Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.43 / $100.97 / $157.86	Facility		$78.43	$100.97	$157.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.43 / $79.72 / $105.86	Professional		$78.43	$79.72	$105.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.47 / $113.87 / $159.47	Facility		$74.47	$113.87	$159.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $78.93 / $85.64	Professional		$78.93	$78.93	$85.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.18 / $171.87 / $211.92	Professional		$77.18	$171.87	$211.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $112.87 / $169.70	Facility		$78.93	$112.87	$169.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $85.29 / $102.61	Professional		$78.93	$85.29	$102.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $78.43 / $80.48 / $163.83	Facility		$78.43	$80.48	$163.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $112.87 / $169.70	Facility		$78.93	$112.87	$169.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $93.09 / $101.79	Professional		$78.93	$93.09	$101.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $128.78 / $295.91	Facility		$83.23	$128.78	$295.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $78.93 / $78.93	Professional		$78.93	$78.93	$78.93
United Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $78.93 / $78.93	Professional		$78.93	$78.93	$78.93