Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.65 / $136.40 / $650.60	Facility		$71.65	$136.40	$650.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $71.65 / $172.95	Professional		$68.20	$71.65	$172.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.34 / $168.30 / $285.79	Facility		$64.34	$168.30	$285.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $77.20	Professional		$68.20	$68.20	$77.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.93 / $170.00 / $442.57	Professional		$124.93	$170.00	$442.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $107.36 / $344.09	Facility		$68.20	$107.36	$344.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $78.43 / $178.40	Professional		$68.20	$78.43	$178.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $81.11 / $800.74	Facility		$68.20	$81.11	$800.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $132.84 / $496.80	Facility		$68.20	$132.84	$496.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $173.05 / $625.58	Professional		$68.20	$173.05	$625.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $74.28 / $976.67 / $1,958.18	Facility		$74.28	$976.67	$1,958.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $75.02	Professional		$68.20	$68.20	$75.02
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $79.11	Professional		$68.20	$68.20	$79.11