Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.30 / $99.27 / $368.58	Facility		$54.30	$99.27	$368.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.25 / $30.42 / $94.56	Professional		$22.25	$30.42	$94.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.88 / $104.53 / $121.36	Facility		$67.88	$104.53	$121.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.94 / $44.01 / $75.19	Professional		$17.94	$44.01	$75.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.77 / $101.75 / $109.78	Professional		$41.77	$101.75	$109.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $24.10 / $41.77 / $87.12	Facility		$24.10	$41.77	$87.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $41.77 / $60.15	Professional		$34.00	$41.77	$60.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.77 / $47.20 / $92.21	Facility		$41.77	$47.20	$92.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.42 / $50.12 / $91.06	Facility		$30.42	$50.12	$91.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.26 / $45.95 / $58.48	Professional		$32.26	$45.95	$58.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $81.45 / $127.11 / $168.51	Facility		$81.45	$127.11	$168.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.54 / $38.01 / $102.56	Professional		$25.54	$38.01	$102.56
United Facility/Professional Professional Modifier Low / Median / High Price $14.26 / $17.54 / $50.12	Professional		$14.26	$17.54	$50.12