Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.97 / $74.88 / $144.59	Facility		$61.97	$74.88	$144.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $55.05 / $77.45	Professional		$27.37	$55.05	$77.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.93 / $135.96 / $183.49	Facility		$83.93	$135.96	$183.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $59.47 / $92.82	Professional		$29.13	$59.47	$92.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.64 / $126.21 / $136.18	Professional		$51.64	$126.21	$136.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.10 / $55.88 / $107.69	Facility		$31.10	$55.88	$107.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.64 / $61.97 / $85.05	Professional		$51.64	$61.97	$85.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.64 / $69.70 / $114.00	Facility		$51.64	$69.70	$114.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $51.64 / $62.48 / $135.96	Facility		$51.64	$62.48	$135.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.64 / $64.55 / $84.54	Professional		$51.64	$64.55	$84.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $100.70 / $159.38 / $213.35	Facility		$100.70	$159.38	$213.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.34 / $65.83 / $127.18	Professional		$46.34	$65.83	$127.18
United Facility/Professional Professional Modifier Low / Median / High Price $21.69 / $29.51 / $61.97	Professional		$21.69	$29.51	$61.97