Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.08 / $56.93 / $109.93	Facility		$49.08	$56.93	$109.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.20 / $38.08 / $76.56	Professional		$31.20	$38.08	$76.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.80 / $98.25 / $126.01	Facility		$63.80	$98.25	$126.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.71 / $45.53 / $77.09	Professional		$23.71	$45.53	$77.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $85.93 / $102.98	Professional		$39.26	$85.93	$102.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.33 / $65.12 / $117.03	Facility		$35.33	$65.12	$117.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $47.11 / $61.30	Professional		$39.26	$47.11	$61.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.26 / $43.19 / $86.67	Facility		$39.26	$43.19	$86.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.15 / $53.00 / $113.85	Facility		$45.15	$53.00	$113.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $47.11 / $61.68	Professional		$43.19	$47.11	$61.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $76.56 / $119.47 / $162.19	Facility		$76.56	$119.47	$162.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.43 / $77.03 / $123.63	Professional		$69.43	$77.03	$123.63
United Facility/Professional Professional Modifier Low / Median / High Price $16.48 / $16.48 / $47.11	Professional		$16.48	$16.48	$47.11