Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $208.08	Facility		$88.43	$88.43	$208.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.35 / $86.35 / $88.43	Professional		$86.35	$86.35	$88.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.86 / $176.86 / $176.86	Facility		$176.86	$176.86	$176.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $173.29 / $207.65	Professional		$77.81	$173.29	$207.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.50 / $123.48 / $185.65	Facility		$54.50	$123.48	$185.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.43 / $102.74 / $174.86	Professional		$44.43	$102.74	$174.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $90.43 / $123.48 / $185.65	Facility		$90.43	$123.48	$185.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $108.38 / $193.98	Professional		$88.43	$108.38	$193.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Professional		$86.70	$86.70	$86.70