Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.05 / $111.65 / $209.99	Facility		$56.05	$111.65	$209.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.77 / $42.60 / $56.20	Professional		$41.77	$42.60	$56.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.34 / $123.69 / $168.72	Facility		$76.34	$123.69	$168.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.74 / $54.10 / $84.01	Professional		$33.74	$54.10	$84.01
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $87.02 / $87.02 / $87.02	Professional		$87.02	$87.02	$87.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.98 / $114.39 / $123.40	Professional		$46.98	$114.39	$123.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.61 / $50.13 / $150.97	Facility		$42.61	$50.13	$150.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.98 / $56.38 / $94.50	Professional		$46.98	$56.38	$94.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.98 / $63.42 / $103.71	Facility		$46.98	$63.42	$103.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.61 / $56.85 / $136.24	Facility		$42.61	$56.85	$136.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.98 / $58.73 / $76.92	Professional		$46.98	$58.73	$76.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.61 / $145.03 / $194.09	Facility		$91.61	$145.03	$194.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $59.90 / $115.69	Professional		$42.00	$59.90	$115.69
United Facility/Professional Professional Modifier Low / Median / High Price $19.73 / $26.85 / $56.38	Professional		$19.73	$26.85	$56.38