Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $58.88 / $67.61	Professional		$39.81	$58.88	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $85.11 / $102.33	Professional		$81.28	$85.11	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $141.25 / $169.82	Professional		$120.23	$141.25	$169.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $66.07 / $144.54	Facility		$53.70	$66.07	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $72.44	Professional		$42.66	$58.88	$72.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $57.54 / $63.10	Facility		$47.86	$57.54	$63.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $69.18 / $128.82	Facility		$52.48	$69.18	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $128.82	Professional		$93.33	$120.23	$128.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $125.89 / $154.88	Facility		$95.50	$125.89	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $169.82	Professional		$75.86	$114.82	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $141.25 / $181.97	Facility		$112.20	$141.25	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $169.82	Professional		$75.86	$117.49	$169.82