Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.84 / $164.84 / $164.84	Facility		$164.84	$164.84	$164.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $187.48	Professional		$161.62	$161.62	$187.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.47 / $243.12 / $337.84	Facility		$152.47	$243.12	$337.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $190.59	Professional		$161.62	$161.62	$190.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $276.58 / $382.52 / $491.86	Professional		$276.58	$382.52	$491.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $164.84 / $347.48	Facility		$161.62	$164.84	$347.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $182.12 / $210.11	Professional		$161.62	$182.12	$210.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $155.50 / $164.84 / $342.11	Facility		$155.50	$164.84	$342.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $214.76 / $491.32	Facility		$161.62	$214.76	$491.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $344.93 / $359.38	Professional		$161.62	$344.93	$359.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $153.54 / $161.62 / $161.62	Professional		$153.54	$161.62	$161.62
United Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $185.86	Professional		$161.62	$161.62	$185.86