Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $104.71 / $338.84	Facility		$39.81	$104.71	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $28.18 / $162.18	Professional		$19.05	$28.18	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $72.44 / $95.50	Facility		$44.67	$72.44	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $26.92 / $48.98	Professional		$17.78	$26.92	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $58.88 / $69.18	Professional		$26.92	$58.88	$69.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $190.55	Facility		$26.92	$26.92	$190.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $31.62 / $38.90	Professional		$26.92	$31.62	$38.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $51.29	Facility		$26.92	$26.92	$51.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $38.90 / $81.28	Facility		$26.30	$38.90	$81.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.88 / $79.43	Professional		$26.92	$33.88	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $81.28 / $112.20	Facility		$40.74	$81.28	$112.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $26.92 / $33.88	Professional		$20.42	$26.92	$33.88
United Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $32.36 / $43.65	Facility		$32.36	$32.36	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $13.80 / $32.36	Professional		$11.48	$13.80	$32.36