Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.50 / $187.79 / $482.98	Facility		$57.50	$187.79	$482.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $37.29 / $70.34	Professional		$30.25	$37.29	$70.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.80 / $103.36 / $121.87	Facility		$63.80	$103.36	$121.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $44.01 / $70.48	Professional		$24.33	$44.01	$70.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $95.44 / $102.98	Professional		$39.26	$95.44	$102.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.78 / $81.87 / $307.80	Facility		$30.78	$81.87	$307.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $45.15 / $55.98	Professional		$39.26	$45.15	$55.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.26 / $41.22 / $86.67	Facility		$39.26	$41.22	$86.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.78 / $47.11 / $103.36	Facility		$30.78	$47.11	$103.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $43.88 / $58.10	Professional		$39.26	$43.88	$58.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $76.56 / $119.47 / $162.19	Facility		$76.56	$119.47	$162.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.68 / $43.27 / $96.82	Professional		$34.68	$43.27	$96.82
United Facility/Professional Facility Modifier Low / Median / High Price $58.89 / $58.89 / $62.82	Facility		$58.89	$58.89	$62.82
United Facility/Professional Professional Modifier Low / Median / High Price $16.48 / $19.39 / $47.11	Professional		$16.48	$19.39	$47.11