Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.72 / $67.72 / $67.72	Facility		$67.72	$67.72	$67.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $98.86	Professional		$91.54	$91.54	$98.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.36 / $97.71 / $137.12	Facility		$86.36	$97.71	$137.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $107.95	Professional		$91.54	$91.54	$107.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.94 / $164.86 / $197.29	Professional		$133.94	$164.86	$197.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.72 / $91.54 / $195.90	Facility		$67.72	$91.54	$195.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $97.03 / $114.43	Professional		$91.54	$97.03	$114.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.86 / $91.54 / $189.99	Facility		$62.86	$91.54	$189.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.76 / $91.54 / $176.00	Facility		$80.76	$91.54	$176.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.76 / $86.30 / $99.96	Professional		$80.76	$86.30	$99.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $86.96 / $91.54 / $91.54	Professional		$86.96	$91.54	$91.54
United Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $105.27	Professional		$91.54	$91.54	$105.27