Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.92 / $107.92 / $107.92	Facility		$107.92	$107.92	$107.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $367.61	Professional		$97.94	$97.94	$367.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $145.46 / $200.34	Facility		$92.40	$145.46	$200.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $115.50	Professional		$97.94	$97.94	$115.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $187.95 / $250.52 / $294.57	Professional		$187.95	$250.52	$294.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $107.92 / $222.70	Facility		$97.94	$107.92	$222.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $108.96 / $127.32	Professional		$97.94	$108.96	$127.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $89.04 / $101.64 / $223.98	Facility		$89.04	$101.64	$223.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $128.49 / $222.70	Facility		$97.94	$128.49	$222.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $187.28 / $206.25	Professional		$97.94	$187.28	$206.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $120.78 / $131.47 / $300.74	Facility		$120.78	$131.47	$300.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $97.94 / $97.94	Professional		$93.04	$97.94	$97.94
United Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $112.63	Professional		$97.94	$97.94	$112.63