Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.58 / $162.28 / $178.68	Facility		$104.58	$162.28	$178.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $98.28 / $179.67	Professional		$89.34	$98.28	$179.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.29 / $226.39 / $237.50	Facility		$84.29	$226.39	$237.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $118.75	Professional		$89.34	$89.34	$118.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $178.00 / $242.05 / $350.63	Professional		$178.00	$242.05	$350.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $114.27 / $208.64	Facility		$89.34	$114.27	$208.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $98.28 / $136.19	Professional		$89.34	$98.28	$136.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $111.68 / $268.02	Facility		$89.34	$111.68	$268.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $133.13 / $226.39	Facility		$89.34	$133.13	$226.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $96.93 / $163.59 / $169.74	Professional		$96.93	$163.59	$169.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $132.80 / $199.20 / $470.34	Facility		$132.80	$199.20	$470.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $107.21	Professional		$89.34	$89.34	$107.21
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $102.74	Professional		$89.34	$89.34	$102.74