Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $138.04 / $181.97	Facility		$74.13	$138.04	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $75.86 / $128.82	Professional		$74.13	$75.86	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $128.82 / $151.36	Facility		$70.79	$128.82	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $85.11	Professional		$74.13	$74.13	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $162.18 / $190.55	Professional		$117.49	$162.18	$190.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $79.43 / $147.91	Facility		$74.13	$79.43	$147.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $83.18 / $114.82	Professional		$74.13	$83.18	$114.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $93.33 / $154.88	Facility		$75.86	$93.33	$154.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $83.18 / $151.36	Facility		$74.13	$83.18	$151.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $83.18 / $100.00	Professional		$74.13	$83.18	$100.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $151.36 / $281.84	Facility		$89.13	$151.36	$281.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $74.13 / $104.71	Professional		$70.79	$74.13	$104.71
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