Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $252.20 / $384.94	Facility		$78.00	$252.20	$384.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.49 / $39.06 / $63.32	Professional		$36.49	$39.06	$63.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $125.39 / $167.67	Facility		$77.40	$125.39	$167.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.99 / $54.52 / $85.18	Professional		$34.99	$54.52	$85.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.63 / $115.94 / $125.12	Professional		$47.63	$115.94	$125.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $37.97 / $59.89 / $141.57	Facility		$37.97	$59.89	$141.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.63 / $54.77 / $68.59	Professional		$47.63	$54.77	$68.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.63 / $57.16 / $105.14	Facility		$47.63	$57.16	$105.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $37.97 / $57.63 / $138.13	Facility		$37.97	$57.63	$138.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.63 / $57.16 / $77.98	Professional		$47.63	$57.16	$77.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $92.88 / $147.03 / $196.78	Facility		$92.88	$147.03	$196.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $60.72 / $117.33	Professional		$42.58	$60.72	$117.33
United Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $27.23 / $57.16	Professional		$20.00	$27.23	$57.16