Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.47 / $98.09 / $163.29	Facility		$78.47	$98.09	$163.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $79.25 / $136.54	Professional		$78.37	$79.25	$136.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.93 / $130.91 / $155.04	Facility		$73.93	$130.91	$155.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.37 / $88.72	Professional		$78.37	$78.37	$88.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.74 / $172.58 / $210.97	Professional		$136.74	$172.58	$210.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $78.47 / $144.19	Facility		$60.00	$78.47	$144.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $83.07 / $101.88	Professional		$78.37	$83.07	$101.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $90.20 / $235.11	Facility		$78.37	$90.20	$235.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.07 / $81.50 / $144.56	Facility		$63.07	$81.50	$144.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $90.35 / $99.81	Professional		$78.37	$90.35	$99.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $69.41 / $104.12 / $263.26	Facility		$69.41	$104.12	$263.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.37 / $94.04	Professional		$78.37	$78.37	$94.04
United Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.37 / $90.13	Professional		$78.37	$78.37	$90.13