Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $87.10 / $194.98	Facility		$44.67	$87.10	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.88 / $57.54	Professional		$24.55	$33.88	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $100.00 / $134.90	Facility		$61.66	$100.00	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $67.61	Professional		$25.12	$38.02	$67.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $81.28 / $97.72	Professional		$38.02	$81.28	$97.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $117.49	Facility		$38.02	$38.02	$117.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $61.66	Professional		$38.02	$45.71	$61.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $70.79	Facility		$38.02	$38.02	$70.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $54.95 / $112.20	Facility		$36.31	$54.95	$112.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $46.77 / $79.43	Professional		$38.02	$46.77	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $112.20 / $154.88	Facility		$56.23	$112.20	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.02 / $47.86	Professional		$28.18	$38.02	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $45.71 / $60.26	Facility		$45.71	$45.71	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $21.38 / $52.48	Professional		$15.85	$21.38	$52.48