Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.41 / $55.41 / $55.41	Facility		$55.41	$55.41	$55.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.45 / $21.56 / $43.35	Professional		$16.45	$21.56	$43.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.13 / $36.13 / $36.13	Facility		$36.13	$36.13	$36.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.46 / $47.88 / $70.84	Professional		$18.46	$47.88	$70.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.23 / $69.75 / $112.65	Professional		$22.23	$69.75	$112.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $16.45 / $30.01 / $1,925.10	Facility		$16.45	$30.01	$1,925.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.23 / $30.01 / $45.03	Professional		$22.23	$30.01	$45.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $22.23 / $24.45 / $49.07	Facility		$22.23	$24.45	$49.07
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $20.01 / $22.23 / $22.23	Professional		$20.01	$22.23	$22.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.56 / $28.12 / $54.34	Facility		$21.56	$28.12	$54.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.45 / $28.12 / $44.28	Professional		$24.45	$28.12	$44.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $81.80 / $131.36	Professional		$73.02	$81.80	$131.36
United Facility/Professional Professional Modifier Low / Median / High Price $13.34 / $22.23 / $69.14	Professional		$13.34	$22.23	$69.14