Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $60.26 / $177.83	Facility		$48.98	$60.26	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $36.31 / $66.07	Professional		$28.84	$36.31	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $97.72 / $114.82	Facility		$64.57	$97.72	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $43.65 / $70.79	Professional		$30.90	$43.65	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $85.11 / $104.71	Professional		$38.90	$85.11	$104.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $45.71	Facility		$38.90	$38.90	$45.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $54.95	Professional		$38.90	$38.90	$54.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $74.13	Facility		$38.90	$38.90	$74.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $54.95 / $114.82	Facility		$35.48	$54.95	$114.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $51.29 / $79.43	Professional		$38.90	$51.29	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $114.82 / $154.88	Facility		$58.88	$114.82	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $46.77	Professional		$31.62	$33.11	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $63.10	Facility		$46.77	$46.77	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $16.60 / $46.77	Professional		$16.60	$16.60	$46.77