Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $100.00 / $288.40	Facility		$79.43	$100.00	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $47.86 / $100.00	Professional		$21.88	$47.86	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $107.15 / $186.21	Facility		$104.71	$107.15	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $64.57 / $114.82	Professional		$19.50	$64.57	$114.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $138.04 / $165.96	Professional		$64.57	$138.04	$165.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $64.57 / $87.10	Professional		$40.74	$64.57	$87.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $120.23	Facility		$64.57	$64.57	$120.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $89.13 / $190.55	Facility		$57.54	$89.13	$190.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $70.79 / $89.13	Professional		$40.74	$70.79	$89.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $190.55 / $251.19	Facility		$95.50	$190.55	$251.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $54.95 / $77.62	Professional		$30.20	$54.95	$77.62
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $102.33	Facility		$77.62	$77.62	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $26.92 / $77.62	Professional		$16.98	$26.92	$77.62