Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $109.65 / $794.33	Facility		$72.44	$109.65	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $89.13	Professional		$39.81	$54.95	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $83.18	Professional		$66.07	$66.07	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $125.89 / $147.91	Professional		$57.54	$125.89	$147.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $81.28	Facility		$57.54	$57.54	$81.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $97.72	Professional		$57.54	$72.44	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $109.65	Facility		$57.54	$57.54	$109.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $81.28 / $169.82	Facility		$56.23	$81.28	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $74.13 / $95.50	Professional		$57.54	$74.13	$95.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $173.78 / $239.88	Facility		$87.10	$173.78	$239.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $74.13	Professional		$43.65	$57.54	$74.13
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $93.33	Facility		$69.18	$69.18	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.11 / $81.28	Professional		$24.55	$33.11	$81.28