Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Facility		$68.48	$68.48	$68.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $79.44	Professional		$68.48	$68.48	$79.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.61 / $96.92 / $136.97	Facility		$64.61	$96.92	$136.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $80.76	Professional		$68.48	$68.48	$80.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.86 / $167.21 / $196.38	Professional		$135.86	$167.21	$196.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $68.48 / $146.57	Facility		$66.00	$68.48	$146.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $78.76 / $89.04	Professional		$68.48	$78.76	$89.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.31 / $68.48 / $142.46	Facility		$67.31	$68.48	$142.46
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.84 / $75.34 / $136.97	Facility		$67.84	$75.34	$136.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $83.39 / $98.84	Professional		$68.48	$83.39	$98.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $68.48 / $68.48	Professional		$65.06	$68.48	$68.48
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $78.76	Professional		$68.48	$68.48	$78.76