Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $61.09 / $117.96	Facility		$42.13	$61.09	$117.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $49.66	Professional		$42.13	$42.13	$49.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.45 / $105.41 / $122.39	Facility		$68.45	$105.41	$122.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $48.95 / $75.78	Professional		$22.91	$48.95	$75.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $102.54 / $110.64	Professional		$42.13	$102.54	$110.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $90.58	Facility		$42.13	$42.13	$90.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $48.45 / $57.30	Professional		$42.13	$48.45	$57.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $46.34 / $63.20	Facility		$42.13	$46.34	$63.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $50.56 / $105.41	Facility		$42.13	$50.56	$105.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.02 / $46.34 / $58.98	Professional		$40.02	$46.34	$58.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $71.79 / $124.36 / $165.40	Facility		$71.79	$124.36	$165.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $64.04 / $104.20	Professional		$37.65	$64.04	$104.20
United Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $17.73 / $50.66	Professional		$17.64	$17.73	$50.66