Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.70 / $170.00 / $354.55	Facility		$97.70	$170.00	$354.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $144.32 / $423.00	Professional		$114.54	$144.32	$423.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.05 / $130.38 / $250.60	Facility		$108.05	$130.38	$250.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $124.26	Professional		$114.54	$114.54	$124.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.32 / $214.49 / $248.47	Professional		$96.32	$214.49	$248.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $114.54 / $163.79 / $630.96	Facility		$114.54	$163.79	$630.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $125.99 / $204.80	Professional		$114.54	$125.99	$204.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.70 / $129.66 / $343.62	Facility		$97.70	$129.66	$343.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.54 / $170.33 / $367.20	Facility		$114.54	$170.33	$367.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $140.47 / $208.53	Professional		$114.54	$140.47	$208.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.88 / $200.31 / $430.26	Facility		$131.88	$200.31	$430.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $114.54	Professional		$114.54	$114.54	$114.54
United Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $114.54	Professional		$114.54	$114.54	$114.54