Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $194.98	Facility		$97.72	$97.72	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $72.44 / $138.04	Professional		$39.81	$72.44	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $107.15 / $218.78	Professional		$56.23	$107.15	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $109.65 / $177.83	Professional		$56.23	$109.65	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $75.86 / $120.23	Facility		$40.74	$75.86	$120.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $93.33 / $181.97	Professional		$46.77	$93.33	$181.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $158.49 / $162.18	Facility		$95.50	$158.49	$162.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $74.13 / $120.23	Facility		$40.74	$74.13	$120.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $93.33 / $199.53	Professional		$48.98	$93.33	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $190.55	Professional		$74.13	$109.65	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $112.20 / $199.53	Professional		$66.07	$112.20	$199.53