Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $108.66 / $183.92	Facility		$42.28	$108.66	$183.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $42.28 / $49.66	Professional		$42.28	$42.28	$49.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.70 / $105.80 / $122.84	Facility		$68.70	$105.80	$122.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.26 / $48.57 / $60.71	Professional		$42.26	$48.57	$60.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $103.33 / $111.49	Professional		$42.28	$103.33	$111.49
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $42.28 / $90.90	Facility		$42.28	$42.28	$90.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $50.74 / $57.50	Professional		$42.28	$50.74	$57.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $44.39 / $59.19	Facility		$42.28	$44.39	$59.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $50.74 / $102.92	Facility		$42.28	$50.74	$102.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.17 / $46.51 / $59.19	Professional		$40.17	$46.51	$59.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $71.79 / $124.81 / $165.99	Facility		$71.79	$124.81	$165.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $37.94 / $58.31 / $104.20	Professional		$37.94	$58.31	$104.20
United Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $17.73 / $50.66	Professional		$17.64	$17.73	$50.66