Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.80 / $89.18 / $172.20	Facility		$73.80	$89.18	$172.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $43.52 / $89.18	Professional		$40.13	$43.52	$89.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.95 / $153.91 / $178.71	Facility		$99.95	$153.91	$178.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $64.88 / $110.44	Professional		$24.69	$64.88	$110.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.50 / $149.88 / $161.71	Professional		$61.50	$149.88	$161.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.43 / $61.50 / $128.27	Facility		$28.43	$61.50	$128.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $61.50 / $73.80	Professional		$46.80	$61.50	$73.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $55.35 / $64.58 / $135.76	Facility		$55.35	$64.58	$135.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.79 / $73.80 / $134.07	Facility		$44.79	$73.80	$134.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.75 / $67.65 / $86.10	Professional		$46.75	$67.65	$86.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $119.93 / $187.14 / $241.44	Facility		$119.93	$187.14	$241.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $55.97 / $151.79	Professional		$35.15	$55.97	$151.79
United Facility/Professional Professional Modifier Low / Median / High Price $19.64 / $25.83 / $73.80	Professional		$19.64	$25.83	$73.80