Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $269.15 / $323.59	Professional		$251.19	$269.15	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $288.40 / $478.63	Facility		$251.19	$288.40	$478.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $269.15 / $316.23	Professional		$251.19	$269.15	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $302.00	Facility		$288.40	$288.40	$302.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $281.84 / $407.38	Facility		$239.88	$281.84	$407.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $79.43	Professional		$13.18	$13.18	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04