Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.20 / $60.55 / $116.93	Facility		$52.20	$60.55	$116.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.50 / $40.51 / $81.43	Professional		$35.50	$40.51	$81.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.84 / $104.49 / $149.88	Facility		$67.84	$104.49	$149.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $54.26 / $82.23	Professional		$28.07	$54.26	$82.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.76 / $91.61 / $109.78	Professional		$41.76	$91.61	$109.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $37.58 / $77.48 / $139.44	Facility		$37.58	$77.48	$139.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.76 / $46.40 / $72.91	Professional		$41.76	$46.40	$72.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.76 / $45.94 / $92.19	Facility		$41.76	$45.94	$92.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $48.02 / $57.93 / $123.19	Facility		$48.02	$57.93	$123.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.94 / $52.24 / $66.81	Professional		$45.94	$52.24	$66.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $81.43 / $128.88 / $172.53	Facility		$81.43	$128.88	$172.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $73.62 / $82.34 / $131.09	Professional		$73.62	$82.34	$131.09
United Facility/Professional Professional Modifier Low / Median / High Price $17.54 / $17.54 / $50.11	Professional		$17.54	$17.54	$50.11