Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.86 / $97.03 / $163.80	Facility		$82.86	$97.03	$163.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $82.86 / $142.52	Professional		$81.90	$82.86	$142.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.26 / $134.75 / $157.72	Facility		$77.26	$134.75	$157.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $92.72	Professional		$81.90	$81.90	$92.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.06 / $181.74 / $222.26	Professional		$144.06	$181.74	$222.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $86.00 / $176.09	Facility		$81.90	$86.00	$176.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $86.81 / $106.47	Professional		$81.90	$86.81	$106.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $94.26 / $245.70	Facility		$81.90	$94.26	$245.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $93.30 / $166.60	Facility		$81.90	$93.30	$166.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $93.30 / $104.30	Professional		$81.90	$93.30	$104.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $70.50 / $105.75 / $271.55	Facility		$70.50	$105.75	$271.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $98.28	Professional		$81.90	$81.90	$98.28
United Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $94.19	Professional		$81.90	$81.90	$94.19