Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.94 / $108.68 / $174.56	Facility		$86.94	$108.68	$174.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.94 / $88.16 / $105.37	Professional		$86.94	$88.16	$105.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $82.34 / $169.60	Facility		$82.34	$82.34	$169.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $94.69	Professional		$87.28	$87.28	$94.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.79 / $188.31 / $221.30	Professional		$85.79	$188.31	$221.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $124.81 / $187.65	Facility		$87.28	$124.81	$187.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $96.01 / $113.46	Professional		$87.28	$96.01	$113.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.94 / $100.46 / $260.82	Facility		$86.94	$100.46	$260.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $124.81 / $252.43	Facility		$82.34	$124.81	$252.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $102.93 / $109.80	Professional		$87.28	$102.93	$109.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $76.34 / $100.24 / $371.78	Facility		$76.34	$100.24	$371.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
United Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28