Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.79 / $63.79 / $123.17	Facility		$52.79	$63.79	$123.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $42.67 / $63.79	Professional		$23.32	$42.67	$63.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.48 / $115.79 / $157.06	Facility		$71.48	$115.79	$157.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.63 / $50.39 / $78.72	Professional		$33.63	$50.39	$78.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $107.29 / $115.74	Professional		$43.99	$107.29	$115.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $23.32 / $47.71 / $129.40	Facility		$23.32	$47.71	$129.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $52.79 / $88.50	Professional		$43.99	$52.79	$88.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43.99 / $59.39 / $235.75	Facility		$43.99	$59.39	$235.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.32 / $53.23 / $127.57	Facility		$23.32	$53.23	$127.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $52.79 / $72.01	Professional		$43.99	$52.79	$72.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $85.78 / $135.78 / $181.74	Facility		$85.78	$135.78	$181.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $56.07 / $108.31	Professional		$39.40	$56.07	$108.31
United Facility/Professional Facility Modifier Low / Median / High Price $27.66 / $27.66 / $43.99	Facility		$27.66	$27.66	$43.99
United Facility/Professional Professional Modifier Low / Median / High Price $18.48 / $21.81 / $52.79	Professional		$18.48	$21.81	$52.79