Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $77.06 / $119.76	Facility		$42.28	$77.06	$119.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.67 / $69.94 / $157.53	Professional		$65.67	$69.94	$157.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.50 / $144.50 / $144.50	Facility		$144.50	$144.50	$144.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.25 / $72.25 / $72.25	Professional		$72.25	$72.25	$72.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $65.67 / $93.91 / $141.19	Facility		$65.67	$93.91	$141.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13,910.16 / $55,799.44 / $116,998.83	Professional		$13,910.16	$55,799.44	$116,998.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $73.40 / $73.40	Facility		$25.00	$73.40	$73.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $65.67 / $93.91 / $190.95	Facility		$65.67	$93.91	$190.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $72.25 / $178.08	Professional		$70.95	$72.25	$178.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.11 / $206.07 / $288.81	Facility		$95.11	$206.07	$288.81
United Facility/Professional Professional Modifier Low / Median / High Price $77.26 / $88.08 / $88.08	Professional		$77.26	$88.08	$88.08