Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.37 / $102.96 / $143.32	Facility		$82.37	$102.96	$143.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $82.37 / $313.33	Professional		$69.73	$82.37	$313.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.78 / $112.34 / $159.00	Facility		$65.78	$112.34	$159.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $75.65	Professional		$69.73	$69.73	$75.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.30 / $174.39 / $209.79	Professional		$52.30	$174.39	$209.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $87.86 / $128.38	Facility		$69.73	$87.86	$128.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $73.91 / $90.65	Professional		$69.73	$73.91	$90.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $90.61 / $209.19	Facility		$69.73	$90.61	$209.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $112.34 / $171.06	Facility		$69.73	$112.34	$171.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $99.24 / $115.53	Professional		$72.06	$99.24	$115.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $80.19	Professional		$69.73	$69.73	$80.19
United Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $82.37	Professional		$69.73	$69.73	$82.37