Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $56.23 / $123.03	Facility		$23.44	$56.23	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.84 / $66.07	Professional		$22.39	$28.84	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Facility		$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $50.12 / $58.88	Professional		$23.44	$50.12	$58.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $24.55 / $63.10	Facility		$23.44	$24.55	$63.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $25.70 / $51.29	Professional		$22.39	$25.70	$51.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $24.55 / $43.65	Facility		$22.39	$24.55	$43.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $33.11 / $66.07	Facility		$21.88	$33.11	$66.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.20 / $79.43	Professional		$22.91	$30.20	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $33.88 / $52.48	Facility		$19.05	$33.88	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Facility		$22.39	$22.39	$22.39
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $25.12 / $25.12	Professional		$23.99	$25.12	$25.12