Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.19 / $137.19 / $137.19	Facility		$137.19	$137.19	$137.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $431.50	Professional		$134.88	$134.88	$431.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.25 / $202.95 / $272.95	Facility		$127.25	$202.95	$272.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $159.06	Professional		$134.88	$134.88	$159.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.94 / $318.02 / $410.34	Professional		$229.94	$318.02	$410.34
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $134.88 / $137.19 / $290.01	Facility		$134.88	$137.19	$290.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $142.97 / $168.61	Professional		$134.88	$142.97	$168.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.88 / $144.44 / $280.57	Facility		$134.88	$144.44	$280.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.88 / $168.95 / $288.66	Facility		$134.88	$168.95	$288.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $169.11 / $182.29	Professional		$134.88	$169.11	$182.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.15 / $134.88 / $134.88	Professional		$128.15	$134.88	$134.88
United Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $155.12	Professional		$134.88	$134.88	$155.12