Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.77 / $54.77 / $105.86	Facility		$54.77	$54.77	$105.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.61 / $73.20 / $131.43	Professional		$40.61	$73.20	$131.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.90 / $68.90 / $68.90	Facility		$68.90	$68.90	$68.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.77 / $110.88 / $217.89	Professional		$63.77	$110.88	$217.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.91 / $109.73 / $190.17	Professional		$65.91	$109.73	$190.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $41.47 / $77.01 / $137.62	Facility		$41.47	$77.01	$137.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $67.25 / $108.46 / $179.87	Professional		$67.25	$108.46	$179.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.30 / $150.36 / $162.13	Facility		$69.30	$150.36	$162.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.12 / $76.88 / $137.62	Facility		$41.12	$76.88	$137.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.20 / $98.59 / $191.92	Professional		$48.20	$98.59	$191.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.64 / $108.77 / $190.72	Professional		$64.64	$108.77	$190.72
United Facility/Professional Professional Modifier Low / Median / High Price $118.04 / $158.88 / $248.64	Professional		$118.04	$158.88	$248.64