Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $85.11 / $251.19	Facility		$69.18	$85.11	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $81.28 / $281.84	Professional		$38.02	$81.28	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $144.54 / $263.03	Facility		$91.20	$144.54	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $79.43 / $100.00	Professional		$38.02	$79.43	$100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $120.23 / $141.25	Professional		$54.95	$120.23	$141.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $64.57 / $79.43	Professional		$54.95	$64.57	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $117.49	Facility		$54.95	$54.95	$117.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $77.62 / $162.18	Facility		$53.70	$77.62	$162.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $61.66 / $87.10	Professional		$54.95	$61.66	$87.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $162.18 / $218.78	Facility		$83.18	$162.18	$218.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $66.07	Professional		$41.69	$50.12	$66.07
United Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $89.13	Facility		$66.07	$66.07	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $66.07	Professional		$23.44	$23.44	$66.07