Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.59 / $84.55 / $137.36	Facility		$54.59	$84.55	$137.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $47.96 / $82.97	Professional		$35.65	$47.96	$82.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.98 / $109.30 / $144.02	Facility		$70.98	$109.30	$144.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $52.36 / $85.45	Professional		$27.02	$52.36	$85.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $95.89 / $114.91	Professional		$43.67	$95.89	$114.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $39.29 / $74.44 / $133.63	Facility		$39.29	$74.44	$133.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $52.40 / $70.04	Professional		$43.67	$52.40	$70.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43.67 / $45.85 / $96.40	Facility		$43.67	$45.85	$96.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.22 / $58.95 / $126.64	Facility		$50.22	$58.95	$126.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.04 / $52.84 / $68.37	Professional		$48.04	$52.84	$68.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $85.16 / $132.88 / $180.42	Facility		$85.16	$132.88	$180.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.20 / $85.74 / $137.49	Professional		$77.20	$85.74	$137.49
United Facility/Professional Professional Modifier Low / Median / High Price $18.34 / $18.34 / $52.40	Professional		$18.34	$18.34	$52.40