Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.25 / $67.56 / $130.47	Facility		$58.25	$67.56	$130.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $44.13 / $90.87	Professional		$38.04	$44.13	$90.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.73 / $116.62 / $153.69	Facility		$75.73	$116.62	$153.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.01 / $55.78 / $83.42	Professional		$41.01	$55.78	$83.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.60 / $102.28 / $122.56	Professional		$46.60	$102.28	$122.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $34.95 / $48.93 / $102.52	Facility		$34.95	$48.93	$102.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.60 / $46.60 / $62.91	Professional		$46.60	$46.60	$62.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.60 / $48.93 / $102.87	Facility		$46.60	$48.93	$102.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $48.93 / $58.95 / $135.13	Facility		$48.93	$58.95	$135.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.26 / $55.92 / $70.08	Professional		$51.26	$55.92	$70.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $90.87 / $141.80 / $192.52	Facility		$90.87	$141.80	$192.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $82.59 / $91.87 / $147.08	Professional		$82.59	$91.87	$147.08
United Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $19.57 / $55.92	Professional		$19.57	$19.57	$55.92