Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.83 / $153.85 / $437.98	Facility		$80.83	$153.85	$437.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.71 / $61.08 / $95.42	Professional		$58.71	$61.08	$95.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.45 / $177.31 / $241.85	Facility		$109.45	$177.31	$241.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.31 / $77.23 / $121.02	Professional		$48.31	$77.23	$121.02
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $63.61 / $63.61 / $63.61	Professional		$63.61	$63.61	$63.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.36 / $164.07 / $177.02	Professional		$67.36	$164.07	$177.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.07 / $71.87 / $202.55	Facility		$61.07	$71.87	$202.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $67.36 / $77.45 / $117.64	Professional		$67.36	$77.45	$117.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.36 / $90.94 / $148.69	Facility		$67.36	$90.94	$148.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.07 / $80.83 / $195.34	Facility		$61.07	$80.83	$195.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.36 / $84.20 / $110.27	Professional		$67.36	$84.20	$110.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.35 / $207.90 / $278.29	Facility		$131.35	$207.90	$278.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.25 / $85.86 / $165.74	Professional		$60.25	$85.86	$165.74
United Facility/Professional Professional Modifier Low / Median / High Price $28.29 / $33.39 / $80.83	Professional		$28.29	$33.39	$80.83