Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.78 / $344.38 / $4,400.35	Facility		$130.78	$344.38	$4,400.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $110.62 / $2,012.52	Professional		$106.33	$110.62	$2,012.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.32 / $230.18 / $327.20	Facility		$100.32	$230.18	$327.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $150.47	Professional		$106.33	$106.33	$150.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.29 / $299.00 / $365.51	Professional		$223.29	$299.00	$365.51
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $136.04 / $459.25	Facility		$106.33	$136.04	$459.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $122.28 / $143.68	Professional		$106.33	$122.28	$143.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $136.04 / $408.12	Facility		$106.33	$136.04	$408.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $161.19 / $417.50	Facility		$106.33	$161.19	$417.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $110.35 / $179.23 / $206.57	Professional		$110.35	$179.23	$206.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $171.87 / $358.35 / $802.62	Facility		$171.87	$358.35	$802.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $127.60	Professional		$106.33	$106.33	$127.60
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $123.34	Professional		$106.33	$106.33	$123.34