Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $97.72 / $154.88	Facility		$37.15	$97.72	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $23.44 / $50.12	Professional		$16.60	$23.44	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $67.61 / $93.33	Facility		$41.69	$67.61	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $25.70 / $46.77	Professional		$16.98	$25.70	$46.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $56.23 / $66.07	Professional		$25.70	$56.23	$66.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $134.90	Facility		$25.70	$25.70	$134.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $52.48	Professional		$25.70	$32.36	$52.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $107.15	Facility		$25.70	$25.70	$107.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $37.15 / $87.10	Facility		$25.12	$37.15	$87.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $79.43	Professional		$25.70	$32.36	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $77.62 / $107.15	Facility		$38.90	$77.62	$107.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.70 / $33.11	Professional		$19.50	$25.70	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $41.69	Facility		$30.90	$30.90	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.79 / $36.31	Professional		$10.96	$14.79	$36.31