Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $87.00 / $168.00	Facility		$72.00	$87.00	$168.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.03 / $58.20 / $90.89	Professional		$20.03	$58.20	$90.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.50 / $150.15 / $174.33	Facility		$97.50	$150.15	$174.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.08 / $63.37 / $107.50	Professional		$12.08	$63.37	$107.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $145.91 / $157.44	Professional		$60.00	$145.91	$157.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.71 / $58.20 / $125.13	Facility		$19.71	$58.20	$125.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $60.00 / $72.00	Professional		$23.03	$60.00	$72.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $54.00 / $63.00 / $132.44	Facility		$54.00	$63.00	$132.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $43.70 / $72.00 / $130.80	Facility		$43.70	$72.00	$130.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.66 / $66.00 / $84.00	Professional		$21.66	$66.00	$84.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $113.10 / $177.11 / $235.55	Facility		$113.10	$177.11	$235.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $53.59 / $147.69	Professional		$17.14	$53.59	$147.69
United Facility/Professional Professional Modifier Low / Median / High Price $9.58 / $25.20 / $72.00	Professional		$9.58	$25.20	$72.00