Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $100.00 / $288.40	Facility		$81.28	$100.00	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $61.66 / $389.05	Professional		$42.66	$61.66	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $169.82 / $229.09	Facility		$104.71	$169.82	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $64.57 / $114.82	Professional		$42.66	$64.57	$114.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $138.04 / $165.96	Professional		$64.57	$138.04	$165.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $107.15	Professional		$64.57	$77.62	$107.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $123.03	Facility		$64.57	$64.57	$123.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $93.33 / $194.98	Facility		$63.10	$93.33	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $114.82	Professional		$64.57	$79.43	$114.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $194.98 / $269.15	Facility		$97.72	$194.98	$269.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $81.28	Professional		$47.86	$64.57	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $102.33	Facility		$77.62	$77.62	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $37.15 / $89.13	Professional		$26.92	$37.15	$89.13