Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $101.50 / $192.38	Facility		$51.31	$101.50	$192.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $97.59	Professional		$51.31	$51.31	$97.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.38 / $83.38 / $149.07	Facility		$83.38	$83.38	$149.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.88 / $59.57 / $98.86	Professional		$27.88	$59.57	$98.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $112.92 / $135.32	Professional		$51.31	$112.92	$135.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $83.60 / $137.75	Facility		$51.31	$83.60	$137.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $69.27	Professional		$51.31	$51.31	$69.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $51.31 / $97.13	Facility		$51.31	$51.31	$97.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.88 / $64.91 / $124.50	Facility		$53.88	$64.91	$124.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $59.01 / $73.89	Professional		$51.31	$59.01	$73.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $87.14 / $141.63 / $201.43	Facility		$87.14	$141.63	$201.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $90.37 / $100.71 / $160.94	Professional		$90.37	$100.71	$160.94
United Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $30.79 / $51.33	Professional		$30.79	$30.79	$51.33