Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $114.82 / $741.31	Facility		$61.66	$114.82	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $75.86	Professional		$33.88	$46.77	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $128.82 / $177.83	Facility		$79.43	$128.82	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $89.13	Professional		$32.36	$48.98	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $107.15 / $125.89	Professional		$48.98	$107.15	$125.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $102.33	Facility		$48.98	$48.98	$102.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $66.07 / $97.72	Professional		$48.98	$66.07	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $95.50	Facility		$48.98	$48.98	$95.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $70.79 / $162.18	Facility		$47.86	$70.79	$162.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $61.66 / $89.13	Professional		$48.98	$61.66	$89.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $147.91 / $204.17	Facility		$74.13	$147.91	$204.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $63.10	Professional		$37.15	$48.98	$63.10
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $77.62	Facility		$58.88	$58.88	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $28.18 / $69.18	Professional		$20.42	$28.18	$69.18