Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.05 / $189.05 / $189.05	Facility		$189.05	$189.05	$189.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $37.43 / $48.60	Professional		$28.00	$37.43	$48.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.97 / $521.92 / $748.97	Facility		$34.97	$521.92	$748.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $48.90 / $146.58	Professional		$48.90	$48.90	$146.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.68 / $73.02 / $83.76	Professional		$61.68	$73.02	$83.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.96 / $48.60 / $141.16	Facility		$30.96	$48.60	$141.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.83 / $138.83 / $138.83	Professional		$138.83	$138.83	$138.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.15 / $62.31 / $238.37	Facility		$51.15	$62.31	$238.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.86 / $48.60 / $196.58	Facility		$30.86	$48.60	$196.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $61.61 / $121.50	Professional		$48.90	$61.61	$121.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $96.92 / $733.72 / $970.46	Facility		$96.92	$733.72	$970.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.90 / $73.29 / $100.19	Professional		$50.90	$73.29	$100.19
United Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $32.15 / $97.37	Professional		$21.25	$32.15	$97.37