Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.39 / $96.80 / $158.52	Facility		$79.39	$96.80	$158.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $80.05 / $166.68	Professional		$79.26	$80.05	$166.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.77 / $109.16 / $153.90	Facility		$74.77	$109.16	$153.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $85.99	Professional		$79.26	$79.26	$85.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.14 / $174.00 / $202.55	Professional		$78.14	$174.00	$202.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $79.26 / $113.34 / $170.41	Facility		$79.26	$113.34	$170.41
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $84.01 / $103.04	Professional		$79.26	$84.01	$103.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.26 / $99.08 / $164.86	Facility		$79.26	$99.08	$164.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.26 / $83.61 / $148.91	Facility		$77.26	$83.61	$148.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $93.08 / $96.41	Professional		$79.26	$93.08	$96.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $69.76 / $91.15 / $240.55	Facility		$69.76	$91.15	$240.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $79.26	Professional		$79.26	$79.26	$79.26
United Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $79.26 / $79.26	Professional		$79.26	$79.26	$79.26