Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $102.33 / $158.49	Facility		$43.65	$102.33	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $26.92 / $57.54	Professional		$25.12	$26.92	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $93.33 / $125.89	Facility		$57.54	$93.33	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.02 / $54.95	Professional		$23.44	$38.02	$54.95
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $75.86 / $91.20	Professional		$35.48	$75.86	$91.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $79.43	Facility		$35.48	$35.48	$79.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $41.69 / $57.54	Professional		$35.48	$41.69	$57.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $66.07	Facility		$35.48	$35.48	$66.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $48.98 / $104.71	Facility		$31.62	$48.98	$104.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $45.71 / $79.43	Professional		$35.48	$45.71	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $104.71 / $144.54	Facility		$52.48	$104.71	$144.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.11 / $44.67	Professional		$27.54	$33.11	$44.67
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $56.23	Facility		$41.69	$41.69	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.95 / $48.98	Professional		$14.79	$19.95	$48.98