Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $186.21 / $707.95	Facility		$93.33	$186.21	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $269.15	Professional		$93.33	$97.72	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $128.82 / $181.97	Facility		$89.13	$128.82	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $102.33	Professional		$93.33	$93.33	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $204.17 / $239.88	Professional		$93.33	$204.17	$239.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $100.00 / $199.53	Facility		$85.11	$100.00	$199.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $100.00 / $144.54	Professional		$41.69	$100.00	$144.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $117.49 / $194.98	Facility		$95.50	$117.49	$194.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $128.82 / $269.15	Facility		$93.33	$128.82	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $95.50 / $107.15	Professional		$77.62	$95.50	$107.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $144.54 / $288.40	Facility		$87.10	$144.54	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $223.87	Facility		$93.33	$93.33	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33