Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $660.69	Facility		$117.49	$117.49	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $794.33	Professional		$660.69	$660.69	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,202.26 / $1,445.44	Facility		$630.96	$1,202.26	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $776.25	Professional		$660.69	$660.69	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $323.59	Professional		$169.82	$263.03	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $660.69 / $954.99	Facility		$141.25	$660.69	$954.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $380.19	Professional		$165.96	$251.19	$380.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $724.44 / $1,000.00	Facility		$660.69	$724.44	$1,000.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $691.83 / $1,096.48	Facility		$239.88	$691.83	$1,096.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $1,096.48	Professional		$79.43	$125.89	$1,096.48
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 / $158.49 / $1,000.00	Professional		$125.89	$158.49	$1,000.00