Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $107.15 / $177.83	Facility		$74.13	$107.15	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $74.13 / $93.33	Professional		$72.44	$74.13	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $120.23 / $141.25	Facility		$69.18	$120.23	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $83.18	Professional		$74.13	$74.13	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $190.55	Professional		$114.82	$158.49	$190.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $77.62 / $147.91	Facility		$74.13	$77.62	$147.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $77.62 / $102.33	Professional		$69.18	$77.62	$102.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $93.33 / $154.88	Facility		$74.13	$93.33	$154.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $75.86 / $134.90	Facility		$74.13	$75.86	$134.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $79.43 / $93.33	Professional		$74.13	$79.43	$93.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $112.20 / $213.80	Facility		$60.26	$112.20	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $81.28	Professional		$74.13	$74.13	$81.28
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 / $83.18	Professional		$74.13	$74.13	$83.18