Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $58.88 / $173.78	Facility		$47.86	$58.88	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $28.84 / $58.88	Professional		$12.02	$28.84	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $112.20	Facility		$63.10	$63.10	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $38.90 / $69.18	Professional		$8.91	$38.90	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $83.18 / $97.72	Professional		$38.90	$83.18	$97.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $38.90 / $52.48	Professional		$19.05	$38.90	$52.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $72.44	Facility		$38.90	$38.90	$72.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $53.70 / $114.82	Facility		$37.15	$53.70	$114.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $42.66 / $75.86	Professional		$18.20	$42.66	$75.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $112.20 / $151.36	Facility		$57.54	$112.20	$151.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $33.11 / $46.77	Professional		$14.45	$33.11	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $61.66	Facility		$46.77	$46.77	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $16.22 / $46.77	Professional		$8.13	$16.22	$46.77