Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $123.03 / $269.15	Facility		$53.70	$123.03	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.90 / $77.62	Professional		$30.90	$38.90	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $112.20 / $154.88	Facility		$69.18	$112.20	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $46.77 / $85.11	Professional		$28.18	$46.77	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $91.20 / $112.20	Professional		$42.66	$91.20	$112.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $144.54	Facility		$42.66	$42.66	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $51.29 / $74.13	Professional		$42.66	$51.29	$74.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $89.13	Facility		$42.66	$42.66	$89.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $66.07 / $128.82	Facility		$40.74	$66.07	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $79.43	Professional		$42.66	$56.23	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $128.82 / $177.83	Facility		$64.57	$128.82	$177.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $36.31 / $51.29	Professional		$34.67	$36.31	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $69.18	Facility		$51.29	$51.29	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $24.55 / $51.29	Professional		$17.78	$24.55	$51.29