Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $117.49 / $117.49	Facility		$64.57	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $66.07 / $81.28	Professional		$64.57	$66.07	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $91.20 / $128.82	Facility		$61.66	$91.20	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $74.13	Professional		$66.07	$66.07	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $323.59	Professional		$151.36	$245.47	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $81.28 / $147.91	Facility		$66.07	$81.28	$147.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $245.47 / $316.23	Professional		$141.25	$245.47	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $97.72	Facility		$66.07	$66.07	$97.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $79.43 / $199.53	Facility		$66.07	$79.43	$199.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $138.04	Professional		$79.43	$125.89	$138.04
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 / $151.36 / $151.36	Professional		$125.89	$151.36	$151.36