Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $89.18 / $1,532.38	Facility		$89.18	$89.18	$1,532.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $397.77	Professional		$106.70	$106.70	$397.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $100.66 / $193.65	Facility		$75.00	$100.66	$193.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $125.83	Professional		$106.70	$106.70	$125.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $171.45 / $217.72 / $391.83	Professional		$171.45	$217.72	$391.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $106.70 / $229.41	Facility		$89.18	$106.70	$229.41
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $113.10 / $138.71	Professional		$106.70	$113.10	$138.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $106.70 / $266.58	Facility		$89.18	$106.70	$266.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $139.78 / $302.26	Facility		$106.70	$139.78	$302.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $188.91 / $259.64	Professional		$106.70	$188.91	$259.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.37 / $106.70 / $106.70	Professional		$101.37	$106.70	$106.70
United Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $122.71	Professional		$106.70	$106.70	$122.71