Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $114.82 / $190.55	Facility		$75.86	$114.82	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $77.62 / $102.33	Professional		$75.86	$77.62	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $114.82 / $158.49	Facility		$72.44	$114.82	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $83.18	Professional		$75.86	$75.86	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $169.82 / $204.17	Professional		$75.86	$169.82	$204.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $81.28 / $151.36	Facility		$75.86	$81.28	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $83.18 / $100.00	Professional		$75.86	$83.18	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $79.43 / $138.04	Facility		$77.62	$79.43	$138.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $109.65 / $239.88	Facility		$75.86	$109.65	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $79.43 / $89.13	Professional		$75.86	$79.43	$89.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $128.82 / $263.03	Facility		$83.18	$128.82	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $79.43	Professional		$75.86	$75.86	$79.43