Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $163.19 / $384.00	Facility		$163.19	$163.19	$384.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.36 / $159.36 / $163.19	Professional		$159.36	$159.36	$163.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $326.39 / $326.39 / $326.39	Facility		$326.39	$326.39	$326.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $159.36 / $227.88 / $342.62	Facility		$159.36	$227.88	$342.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $182.67 / $215.88 / $215.88	Professional		$182.67	$215.88	$215.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $160.00 / $79,999.20	Facility		$160.00	$160.00	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $176.00 / $184.00 / $320.00	Facility		$176.00	$184.00	$320.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $200.00 / $200.00	Professional		$163.19	$200.00	$200.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $249.44 / $538.16	Facility		$163.19	$249.44	$538.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $160.00	Professional		$160.00	$160.00	$160.00