Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $186.21 / $309.03	Facility		$128.82	$186.21	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $181.97	Professional		$128.82	$134.90	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $181.97 / $257.04	Facility		$123.03	$181.97	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $141.25	Professional		$128.82	$128.82	$141.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $281.84 / $331.13	Professional		$128.82	$281.84	$331.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $138.04 / $257.04	Facility		$128.82	$138.04	$257.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $138.04 / $169.82	Professional		$128.82	$138.04	$169.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $229.09	Facility		$128.82	$128.82	$229.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $138.04 / $257.04	Facility		$134.90	$138.04	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $151.36	Professional		$79.43	$128.82	$151.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $147.91 / $371.54	Facility		$125.89	$147.91	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $309.03	Facility		$128.82	$128.82	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82