Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $162.18	Facility		$117.49	$117.49	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $194.98	Professional		$162.18	$162.18	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $245.47 / $338.84	Facility		$151.36	$245.47	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Professional		$162.18	$162.18	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $323.59	Professional		$169.82	$263.03	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $162.18 / $234.42	Facility		$141.25	$162.18	$234.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $245.47 / $316.23	Professional		$162.18	$245.47	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $165.96 / $204.17	Facility		$162.18	$165.96	$204.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $177.83 / $346.74	Facility		$162.18	$177.83	$346.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $234.42	Professional		$79.43	$125.89	$234.42
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 $125.89 / $158.49 / $371.54	Professional		$125.89	$158.49	$371.54