Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.95 / $124.07 / $209.46	Facility		$104.95	$124.07	$209.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $105.78 / $241.04	Professional		$104.73	$105.78	$241.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.80 / $142.55 / $201.00	Facility		$98.80	$142.55	$201.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $113.62	Professional		$104.73	$104.73	$113.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.34 / $230.12 / $266.57	Professional		$103.34	$230.12	$266.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $149.76 / $225.17	Facility		$104.73	$149.76	$225.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $111.01 / $136.15	Professional		$104.73	$111.01	$136.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $130.91 / $217.84	Facility		$104.73	$130.91	$217.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $142.55 / $225.17	Facility		$104.73	$142.55	$225.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $119.30 / $125.91	Professional		$104.73	$119.30	$125.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.79 / $149.36 / $337.76	Facility		$91.79	$149.36	$337.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73
United Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73