Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.65 / $128.65 / $128.65	Facility		$128.65	$128.65	$128.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.42 / $104.38 / $139.84	Professional		$85.42	$104.38	$139.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.31 / $118.31 / $118.31	Facility		$118.31	$118.31	$118.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.85 / $92.85 / $92.85	Professional		$92.85	$92.85	$92.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.97 / $220.37 / $271.75	Professional		$177.97	$220.37	$271.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $98.96 / $163.22 / $258.95	Facility		$98.96	$163.22	$258.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $160.21 / $189.72 / $266.83	Professional		$160.21	$189.72	$266.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $148.74 / $203.68 / $210.12	Facility		$148.74	$203.68	$210.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $98.96 / $186.26 / $266.01	Facility		$98.96	$186.26	$266.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $119.72 / $213.13 / $278.52	Professional		$119.72	$213.13	$278.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $167.87 / $220.88 / $289.52	Professional		$167.87	$220.88	$289.52
United Facility/Professional Professional Modifier Low / Median / High Price $135.84 / $204.71 / $314.20	Professional		$135.84	$204.71	$314.20