Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $74.56 / $223.72	Facility		$42.13	$74.56	$223.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $77.14	Professional		$42.13	$42.13	$77.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.58 / $128.71 / $149.43	Facility		$83.58	$128.71	$149.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.42 / $59.10 / $73.88	Professional		$51.42	$59.10	$73.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.43 / $125.42 / $135.32	Professional		$51.43	$125.42	$135.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $51.43 / $90.58	Facility		$42.13	$51.43	$90.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.43 / $59.14 / $69.94	Professional		$51.43	$59.14	$69.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.43 / $56.57 / $77.15	Facility		$51.43	$56.57	$77.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $61.72 / $128.71	Facility		$42.13	$61.72	$128.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.86 / $56.57 / $70.97	Professional		$48.86	$56.57	$70.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $71.79 / $127.87 / $201.90	Facility		$71.79	$127.87	$201.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.06 / $64.04 / $127.18	Professional		$46.06	$64.04	$127.18
United Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $17.73 / $50.66	Professional		$17.64	$17.73	$50.66