Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $131.83 / $208.93	Facility		$58.88	$131.83	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $91.20	Professional		$33.88	$42.66	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $123.03 / $169.82	Facility		$75.86	$123.03	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $83.18	Professional		$30.90	$46.77	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $102.33 / $120.23	Professional		$46.77	$102.33	$120.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $158.49	Facility		$46.77	$46.77	$158.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $95.50	Professional		$46.77	$60.26	$95.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $91.20	Facility		$46.77	$46.77	$91.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $67.61 / $151.36	Facility		$45.71	$67.61	$151.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $58.88 / $83.18	Professional		$46.77	$58.88	$83.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $141.25 / $194.98	Facility		$70.79	$141.25	$194.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $46.77 / $60.26	Professional		$35.48	$46.77	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $75.86	Facility		$56.23	$56.23	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $66.07	Professional		$19.95	$26.92	$66.07