Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $107.15 / $27,542.29	Facility		$72.44	$107.15	$27,542.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $194.98	Professional		$72.44	$79.43	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $123.03 / $144.54	Facility		$69.18	$123.03	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $83.18	Professional		$74.13	$74.13	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $186.21	Professional		$120.23	$158.49	$186.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $77.62 / $144.54	Facility		$74.13	$77.62	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $77.62 / $147.91	Professional		$72.44	$77.62	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $117.49	Facility		$72.44	$72.44	$117.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $79.43 / $134.90	Facility		$74.13	$79.43	$134.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $79.43 / $93.33	Professional		$74.13	$79.43	$93.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $117.49 / $239.88	Facility		$79.43	$117.49	$239.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $81.28	Professional		$74.13	$74.13	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $177.83	Facility		$74.13	$74.13	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $85.11	Professional		$74.13	$74.13	$85.11