Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $239.88 / $398.11	Facility		$169.82	$239.88	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $213.80	Professional		$169.82	$169.82	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $263.03 / $323.59	Facility		$158.49	$263.03	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $181.97	Professional		$169.82	$169.82	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $354.81 / $416.87	Professional		$165.96	$354.81	$416.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $177.83 / $338.84	Facility		$169.82	$177.83	$338.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $218.78	Professional		$169.82	$177.83	$218.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $208.93 / $346.74	Facility		$165.96	$208.93	$346.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $263.03 / $457.09	Facility		$169.82	$263.03	$457.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $173.78 / $194.98	Professional		$79.43	$173.78	$194.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $208.93 / $446.68	Facility		$95.50	$208.93	$446.68
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $407.38	Facility		$169.82	$169.82	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82