Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $117.49 / $117.49	Facility		$89.13	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $117.49	Professional		$89.13	$89.13	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $123.03 / $181.97	Facility		$85.11	$123.03	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $102.33	Professional		$89.13	$89.13	$102.33
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 $89.13 / $138.04 / $141.25	Facility		$89.13	$138.04	$141.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $239.88 / $316.23	Professional		$141.25	$239.88	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $89.13 / $144.54	Facility		$83.18	$89.13	$144.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $104.71 / $239.88	Facility		$89.13	$104.71	$239.88
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 $125.89 / $151.36 / $223.87	Professional		$125.89	$151.36	$223.87