Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.17 / $117.17 / $204.45	Facility		$117.17	$117.17	$204.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.84 / $39.95 / $45.59	Professional		$33.84	$39.95	$45.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.38 / $76.38 / $136.56	Facility		$76.38	$76.38	$136.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $102.99 / $123.40	Professional		$47.00	$102.99	$123.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.25 / $45.59 / $103.40	Facility		$35.25	$45.59	$103.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $47.00 / $63.45	Professional		$47.00	$47.00	$63.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.00 / $49.35 / $65.80	Facility		$47.00	$49.35	$65.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.59 / $62.28 / $119.52	Facility		$45.59	$62.28	$119.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.70 / $51.70 / $65.80	Professional		$51.70	$51.70	$65.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.65 / $143.02 / $184.51	Facility		$91.65	$143.02	$184.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.27 / $88.71 / $147.91	Professional		$75.27	$88.71	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $19.73 / $19.73 / $49.35	Professional		$19.73	$19.73	$49.35