Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.28 / $66.80 / $129.00	Facility		$55.28	$66.80	$129.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.69 / $44.69 / $249.94	Professional		$44.69	$44.69	$249.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.88 / $121.30 / $163.75	Facility		$74.88	$121.30	$163.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.03 / $52.86 / $82.83	Professional		$33.03	$52.86	$82.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $112.01 / $120.85	Professional		$46.07	$112.01	$120.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.54 / $49.16 / $142.88	Facility		$33.54	$49.16	$142.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $52.98 / $66.12	Professional		$46.07	$52.98	$66.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.07 / $55.28 / $101.70	Facility		$46.07	$55.28	$101.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.54 / $55.74 / $133.60	Facility		$33.54	$55.74	$133.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $57.59 / $75.43	Professional		$46.07	$57.59	$75.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $89.84 / $142.19 / $190.33	Facility		$89.84	$142.19	$190.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $41.13 / $58.73 / $113.23	Professional		$41.13	$58.73	$113.23
United Facility/Professional Professional Modifier Low / Median / High Price $19.35 / $26.33 / $55.28	Professional		$19.35	$26.33	$55.28