Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $75.86 / $263.03	Facility		$36.31	$75.86	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.92 / $67.61	Professional		$21.88	$26.92	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $77.62 / $104.71	Facility		$47.86	$77.62	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.88 / $81.28	Professional		$22.39	$33.88	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $102.33 / $117.49	Professional		$29.51	$102.33	$117.49
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $112.20	Facility		$29.51	$29.51	$112.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $39.81 / $47.86	Professional		$29.51	$39.81	$47.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $32.36 / $64.57	Facility		$29.51	$32.36	$64.57
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Professional		$29.51	$29.51	$29.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $42.66 / $87.10	Facility		$28.18	$42.66	$87.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $40.74 / $79.43	Professional		$29.51	$40.74	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $87.10 / $120.23	Facility		$43.65	$87.10	$120.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $29.51 / $37.15	Professional		$21.88	$29.51	$37.15
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $46.77	Facility		$35.48	$35.48	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $16.60 / $35.48	Professional		$12.30	$16.60	$35.48