Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.62 / $98.25 / $614.76	Facility		$45.62	$98.25	$614.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.36 / $26.30 / $41.98	Professional		$25.36	$26.30	$41.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.03 / $87.82 / $126.01	Facility		$57.03	$87.82	$126.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.22 / $45.53 / $62.86	Professional		$25.22	$45.53	$62.86
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $39.39 / $39.39 / $39.39	Professional		$39.39	$39.39	$39.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $85.20 / $91.91	Professional		$35.09	$85.20	$91.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.97 / $36.84 / $116.91	Facility		$25.97	$36.84	$116.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $40.35 / $50.53	Professional		$35.09	$40.35	$50.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $38.60 / $77.45	Facility		$35.09	$38.60	$77.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.67 / $42.11 / $101.76	Facility		$26.67	$42.11	$101.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $43.44 / $57.44	Professional		$35.09	$43.44	$57.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $68.43 / $108.33 / $144.97	Facility		$68.43	$108.33	$144.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $31.93 / $65.52 / $93.02	Professional		$31.93	$65.52	$93.02
United Facility/Professional Professional Modifier Low / Median / High Price $14.74 / $14.74 / $42.11	Professional		$14.74	$14.74	$42.11