Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.75 / $99.47 / $192.08	Facility		$85.75	$99.47	$192.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.34 / $60.98 / $133.77	Professional		$10.34	$60.98	$133.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.48 / $171.67 / $246.30	Facility		$111.48	$171.67	$246.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.20 / $89.17 / $134.91	Professional		$46.20	$89.17	$134.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $150.56 / $180.43	Professional		$68.59	$150.56	$180.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.74 / $127.31 / $229.08	Facility		$61.74	$127.31	$229.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $76.22 / $115.84	Professional		$68.59	$76.22	$115.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $75.45 / $151.43	Facility		$68.59	$75.45	$151.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $78.89 / $95.15 / $202.37	Facility		$78.89	$95.15	$202.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.45 / $85.82 / $109.76	Professional		$75.45	$85.82	$109.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $133.77 / $211.73 / $283.41	Facility		$133.77	$211.73	$283.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $134.74 / $215.29	Professional		$120.90	$134.74	$215.29
United Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $56.46 / $224.70	Professional		$41.16	$56.46	$224.70