Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $83.73 / $151.72	Facility		$75.86	$83.73	$151.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $76.62 / $141.82	Professional		$75.86	$76.62	$141.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.56 / $102.53 / $144.54	Facility		$71.56	$102.53	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $82.30	Professional		$75.86	$75.86	$82.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $166.90 / $193.33	Professional		$74.95	$166.90	$193.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.64 / $108.48 / $163.10	Facility		$54.64	$108.48	$163.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $80.41 / $98.62	Professional		$75.86	$80.41	$98.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $94.83 / $227.58	Facility		$75.86	$94.83	$227.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.84 / $75.19 / $112.77	Facility		$66.84	$75.19	$112.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $82.30 / $90.58	Professional		$38.69	$82.30	$90.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.77 / $104.07 / $226.60	Facility		$60.77	$104.07	$226.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86