Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.10 / $85.10 / $85.10	Facility		$85.10	$85.10	$85.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.59 / $70.12 / $93.30	Professional		$56.59	$70.12	$93.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.27 / $79.27 / $79.27	Facility		$79.27	$79.27	$79.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $61.30 / $61.30	Professional		$61.30	$61.30	$61.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.07 / $145.77 / $177.30	Professional		$121.07	$145.77	$177.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.37 / $101.46 / $171.81	Facility		$63.37	$101.46	$171.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.62 / $126.48 / $178.18	Professional		$109.62	$126.48	$178.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.96 / $135.58 / $141.44	Facility		$99.96	$135.58	$141.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.73 / $111.96 / $177.63	Facility		$64.73	$111.96	$177.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.70 / $144.06 / $186.89	Professional		$80.70	$144.06	$186.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.09 / $148.01 / $196.13	Professional		$112.09	$148.01	$196.13
United Facility/Professional Professional Modifier Low / Median / High Price $90.20 / $139.37 / $214.67	Professional		$90.20	$139.37	$214.67