Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.06 / $126.06 / $126.06	Facility		$126.06	$126.06	$126.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $143.61	Professional		$123.80	$123.80	$143.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.79 / $180.44 / $256.86	Facility		$116.79	$180.44	$256.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $145.99	Professional		$123.80	$123.80	$145.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $211.51 / $292.51 / $364.96	Professional		$211.51	$292.51	$364.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $126.06 / $297.00	Facility		$123.80	$126.06	$297.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $135.16 / $160.94	Professional		$123.80	$135.16	$160.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $129.93 / $257.50	Facility		$123.80	$129.93	$257.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $159.38 / $292.89	Facility		$123.80	$159.38	$292.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $161.97 / $292.89	Professional		$123.80	$161.97	$292.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.61 / $123.80 / $123.80	Professional		$117.61	$123.80	$123.80
United Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $142.37	Professional		$123.80	$123.80	$142.37