Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.55 / $62.12 / $119.95	Facility		$53.55	$62.12	$119.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $41.55 / $83.54	Professional		$36.40	$41.55	$83.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.63 / $107.22 / $153.83	Facility		$69.63	$107.22	$153.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.76 / $55.78 / $84.16	Professional		$28.76	$55.78	$84.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $93.75 / $112.35	Professional		$42.84	$93.75	$112.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.56 / $79.48 / $143.59	Facility		$38.56	$79.48	$143.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $51.41 / $74.81	Professional		$42.84	$51.41	$74.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $47.12 / $94.57	Facility		$42.84	$47.12	$94.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $49.27 / $59.42 / $126.38	Facility		$49.27	$59.42	$126.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.12 / $53.59 / $68.54	Professional		$47.12	$53.59	$68.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $83.54 / $132.19 / $176.99	Facility		$83.54	$132.19	$176.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.41 / $84.38 / $134.29	Professional		$75.41	$84.38	$134.29
United Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $24.48 / $51.41	Professional		$17.98	$24.48	$51.41