Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.84 / $74.05 / $194.07	Facility		$63.84	$74.05	$194.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.77 / $58.46 / $99.59	Professional		$36.77	$58.46	$99.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $127.82 / $232.49	Facility		$83.00	$127.82	$232.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.68 / $56.37 / $91.64	Professional		$44.68	$56.37	$91.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.07 / $112.21 / $134.47	Professional		$51.07	$112.21	$134.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.29 / $53.62 / $112.35	Facility		$38.29	$53.62	$112.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.07 / $51.07 / $68.94	Professional		$51.07	$51.07	$68.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.07 / $53.62 / $112.74	Facility		$51.07	$53.62	$112.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.62 / $64.59 / $127.82	Facility		$53.62	$64.59	$127.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.15 / $61.28 / $90.84	Professional		$54.15	$61.28	$90.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $99.59 / $155.41 / $200.50	Facility		$99.59	$155.41	$200.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $90.37 / $100.71 / $160.94	Professional		$90.37	$100.71	$160.94
United Facility/Professional Professional Modifier Low / Median / High Price $21.45 / $21.45 / $53.62	Professional		$21.45	$21.45	$53.62