Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.36 / $65.36 / $65.36	Facility		$65.36	$65.36	$65.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $25.43 / $51.13	Professional		$19.39	$25.43	$51.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.60 / $42.60 / $42.60	Facility		$42.60	$42.60	$42.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $48.64 / $75.55	Professional		$19.79	$48.64	$75.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $74.91 / $120.99	Professional		$26.22	$74.91	$120.99
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $18.89 / $35.40 / $1,970.98	Facility		$18.89	$35.40	$1,970.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $35.40 / $46.96	Professional		$26.22	$35.40	$46.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $26.22 / $28.84 / $51.75	Facility		$26.22	$28.84	$51.75
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $26.22 / $28.84	Professional		$26.22	$26.22	$28.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.43 / $33.17 / $57.68	Facility		$25.43	$33.17	$57.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $31.46 / $47.22	Professional		$28.84	$31.46	$47.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.20 / $87.78 / $139.91	Professional		$77.20	$87.78	$139.91
United Facility/Professional Professional Modifier Low / Median / High Price $15.73 / $18.57 / $81.55	Professional		$15.73	$18.57	$81.55