Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $117.49 / $263.03	Facility		$100.00	$117.49	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $100.00 / $120.23	Professional		$95.50	$100.00	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $204.17 / $204.17	Facility		$102.33	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $323.59	Professional		$151.36	$257.04	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $120.23 / $154.88	Facility		$100.00	$120.23	$154.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $316.23	Professional		$151.36	$245.47	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $120.23 / $204.17	Facility		$97.72	$120.23	$204.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $147.91	Professional		$79.43	$125.89	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $125.89 / $125.89	Professional		$109.65	$125.89	$125.89