Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $117.49 / $117.49	Facility		$91.20	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Professional		$91.20	$91.20	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $97.72 / $138.04	Facility		$87.10	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $100.00	Professional		$91.20	$91.20	$100.00
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 $91.20 / $131.83 / $141.25	Facility		$91.20	$131.83	$141.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $239.88 / $316.23	Professional		$128.82	$239.88	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $91.20 / $138.04	Facility		$63.10	$91.20	$138.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $100.00 / $190.55	Facility		$91.20	$100.00	$190.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $138.04	Professional		$79.43	$123.03	$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 / $154.88	Professional		$125.89	$151.36	$154.88