Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $117.49 / $117.49	Facility		$77.62	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $117.49	Professional		$77.62	$77.62	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $123.03 / $165.96	Facility		$74.13	$123.03	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $89.13	Professional		$77.62	$77.62	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $323.59	Professional		$169.82	$251.19	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $93.33 / $141.25	Facility		$77.62	$93.33	$141.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $239.88 / $316.23	Professional		$109.65	$239.88	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $79.43 / $125.89	Facility		$77.62	$79.43	$125.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $85.11 / $194.98	Facility		$77.62	$85.11	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $154.88	Professional		$79.43	$125.89	$154.88
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 $77.62 / $125.89 / $125.89	Professional		$77.62	$125.89	$125.89