Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $112.20 / $186.21	Facility		$79.43	$112.20	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $81.28 / $100.00	Professional		$79.43	$81.28	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $109.65 / $154.88	Facility		$75.86	$109.65	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $87.10	Professional		$79.43	$79.43	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $165.96 / $199.53	Professional		$77.62	$165.96	$199.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $85.11 / $158.49	Facility		$79.43	$85.11	$158.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $85.11 / $104.71	Professional		$79.43	$85.11	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $97.72 / $162.18	Facility		$77.62	$97.72	$162.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $83.18 / $154.88	Facility		$79.43	$83.18	$154.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $79.43 / $93.33	Professional		$77.62	$79.43	$93.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $181.97	Facility		$79.43	$79.43	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $190.55	Facility		$79.43	$79.43	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43