Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.71 / $2,905.55 / $4,422.09	Facility		$103.71	$2,905.55	$4,422.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.12 / $103.13 / $933.57	Professional		$99.12	$103.13	$933.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.52 / $212.78 / $225.80	Facility		$93.52	$212.78	$225.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $99.13 / $107.54	Professional		$99.13	$99.13	$107.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $227.98 / $329.35	Professional		$99.13	$227.98	$329.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $141.76 / $229.63	Facility		$99.13	$141.76	$229.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $109.04 / $128.87	Professional		$99.13	$109.04	$128.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $117.40 / $311.13	Facility		$99.13	$117.40	$311.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $101.44 / $142.80 / $212.78	Facility		$101.44	$142.80	$212.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $120.58 / $174.24	Professional		$99.13	$120.58	$174.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $165.27 / $359.87 / $708.63	Facility		$165.27	$359.87	$708.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $99.13 / $99.13	Professional		$99.13	$99.13	$99.13
United Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $99.13 / $110.35	Professional		$99.13	$99.13	$110.35