Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $81.28 / $208.93	Facility		$47.86	$81.28	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $30.20 / $58.88	Professional		$21.38	$30.20	$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 $21.38 / $54.95 / $69.18	Professional		$21.38	$54.95	$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 / $81.28	Facility		$38.90	$38.90	$81.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $44.67 / $52.48	Professional		$38.90	$44.67	$52.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $57.54	Facility		$38.90	$38.90	$57.54
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 $38.90 / $42.66 / $60.26	Professional		$38.90	$42.66	$60.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $114.82 / $158.49	Facility		$57.54	$114.82	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $35.48 / $46.77	Professional		$28.84	$35.48	$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 $16.22 / $16.22 / $46.77	Professional		$16.22	$16.22	$46.77