Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $21.88 / $43.65	Professional		$15.85	$21.88	$43.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $52.48 / $61.66	Professional		$23.99	$52.48	$61.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $204.17 / $204.17	Facility		$60.26	$204.17	$204.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $11.22 / $11.22	Professional		$11.22	$11.22	$11.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $47.86 / $47.86	Facility		$39.81	$47.86	$47.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $40.74 / $72.44	Professional		$26.30	$40.74	$72.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $42.66 / $58.88	Professional		$25.12	$42.66	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $10.23 / $28.84	Professional		$6.17	$10.23	$28.84