Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $64.57	Professional		$39.81	$53.70	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $263.03 / $263.03	Professional		$89.13	$263.03	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $123.03 / $151.36	Professional		$109.65	$123.03	$151.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $63.10 / $107.15	Facility		$38.90	$63.10	$107.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $61.66	Professional		$39.81	$52.48	$61.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $93.33 / $112.20	Facility		$40.74	$93.33	$112.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $61.66 / $104.71	Facility		$38.90	$61.66	$104.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $263.03 / $263.03	Professional		$79.43	$263.03	$263.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $363.08 / $467.74	Facility		$269.15	$363.08	$467.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $154.88	Professional		$89.13	$107.15	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $354.81 / $467.74	Facility		$288.40	$354.81	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $109.65 / $162.18	Professional		$67.61	$109.65	$162.18