Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $204.17 / $457.09	Facility		$97.72	$204.17	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $74.13 / $141.25	Professional		$25.12	$74.13	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $229.09	Facility		$128.82	$128.82	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $79.43 / $141.25	Professional		$18.62	$79.43	$141.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $169.82 / $204.17	Professional		$79.43	$169.82	$204.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $302.00	Facility		$79.43	$79.43	$302.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $79.43 / $107.15	Professional		$38.90	$79.43	$107.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $147.91	Facility		$79.43	$79.43	$147.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $109.65 / $234.42	Facility		$39.81	$109.65	$234.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $79.43 / $109.65	Professional		$38.90	$79.43	$109.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $229.09 / $309.03	Facility		$117.49	$229.09	$309.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $67.61 / $95.50	Professional		$28.84	$67.61	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $125.89	Facility		$95.50	$95.50	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $33.11 / $95.50	Professional		$16.22	$33.11	$95.50