Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.11 / $172.76 / $256.58	Facility		$91.11	$172.76	$256.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $742.96 / $1,575.82	Professional		$86.38	$742.96	$1,575.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.48 / $175.44 / $180.82	Facility		$81.48	$175.44	$180.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $93.72	Professional		$86.38	$86.38	$93.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $200.28 / $325.97	Professional		$86.38	$200.28	$325.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $123.52 / $585.00	Facility		$86.38	$123.52	$585.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $95.02 / $131.41	Professional		$86.38	$95.02	$131.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $107.98 / $315.79	Facility		$86.38	$107.98	$315.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $185.72 / $406.77	Facility		$86.38	$185.72	$406.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.71 / $154.97 / $495.63	Professional		$93.71	$154.97	$495.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $260.24 / $437.67 / $930.02	Facility		$260.24	$437.67	$930.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Professional		$86.38	$86.38	$86.38
United Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Professional		$86.38	$86.38	$86.38