Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $44.67 / $269.15	Facility		$19.95	$44.67	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $22.91 / $28.18	Professional		$12.02	$22.91	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $40.74 / $56.23	Facility		$25.12	$40.74	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $15.49 / $27.54	Professional		$10.23	$15.49	$27.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $33.11 / $39.81	Professional		$15.49	$33.11	$39.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $15.49 / $70.79	Facility		$15.49	$15.49	$70.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $20.89 / $28.18	Professional		$15.49	$20.89	$28.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $15.49 / $29.51	Facility		$15.49	$15.49	$29.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $22.39 / $51.29	Facility		$15.14	$22.39	$51.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $19.50 / $79.43	Professional		$15.49	$19.50	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $46.77 / $64.57	Facility		$23.44	$46.77	$64.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $15.49 / $19.95	Professional		$11.75	$15.49	$19.95
United Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $18.62 / $24.55	Facility		$18.62	$18.62	$24.55
United Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $8.91 / $21.88	Professional		$6.46	$8.91	$21.88