Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $56.23 / $251.19	Facility		$15.85	$56.23	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $12.02 / $19.95	Professional		$8.32	$12.02	$19.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $34.67 / $46.77	Facility		$21.38	$34.67	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $13.18 / $23.44	Professional		$8.71	$13.18	$23.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $28.18 / $33.11	Professional		$13.18	$28.18	$33.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $13.18 / $165.96	Facility		$13.18	$13.18	$165.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $17.78 / $22.91	Professional		$13.18	$17.78	$22.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $13.18 / $24.55	Facility		$13.18	$13.18	$24.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $19.05 / $43.65	Facility		$12.59	$19.05	$43.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $16.22 / $79.43	Professional		$13.18	$16.22	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $38.90 / $53.70	Facility		$19.50	$38.90	$53.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $13.18 / $16.60	Professional		$9.77	$13.18	$16.60
United Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $15.85 / $20.89	Facility		$15.85	$15.85	$20.89
United Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $7.41 / $18.20	Professional		$5.50	$7.41	$18.20