Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.32 / $62.32 / $108.75	Facility		$62.32	$62.32	$108.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $21.25 / $24.25	Professional		$18.00	$21.25	$24.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.63 / $40.63 / $72.64	Facility		$40.63	$40.63	$72.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.63 / $14.63 / $14.63	Professional		$14.63	$14.63	$14.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $54.69 / $65.53	Professional		$25.00	$54.69	$65.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $18.75 / $26.25 / $55.00	Facility		$18.75	$26.25	$55.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $27.50 / $35.00	Professional		$25.00	$27.50	$35.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $28.00 / $43.75	Facility		$25.00	$28.00	$43.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.25 / $33.13 / $60.59	Facility		$24.25	$33.13	$60.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $27.50 / $35.00	Professional		$26.25	$27.50	$35.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $76.08 / $98.15	Facility		$50.00	$76.08	$98.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $40.07 / $49.00 / $78.68	Professional		$40.07	$49.00	$78.68
United Facility/Professional Professional Modifier Low / Median / High Price $10.50 / $10.50 / $26.25	Professional		$10.50	$10.50	$26.25