Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $154.88 / $177.83	Facility		$128.82	$154.88	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $104.71	Professional		$51.29	$66.07	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $173.78	Professional		$51.29	$77.62	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $177.83	Professional		$93.33	$131.83	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $79.43 / $123.03	Facility		$61.66	$79.43	$123.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $114.82 / $173.78	Professional		$58.88	$114.82	$173.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $120.23 / $144.54	Facility		$87.10	$120.23	$144.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $77.62 / $123.03	Facility		$61.66	$77.62	$123.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $95.50 / $173.78	Professional		$61.66	$95.50	$173.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $154.88	Professional		$67.61	$97.72	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $102.33 / $169.82	Professional		$14.13	$102.33	$169.82