Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.03 / $74.31 / $118.97	Professional		$44.03	$74.31	$118.97
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $84.68 / $84.68 / $194.11	Professional	25	$84.68	$84.68	$194.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.42 / $97.20 / $201.10	Professional		$50.42	$97.20	$201.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.43 / $125.00 / $196.97	Professional		$83.43	$125.00	$196.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $49.24 / $86.78 / $153.78	Facility		$49.24	$86.78	$153.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.67 / $106.82 / $165.99	Professional		$68.67	$106.82	$165.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.20 / $138.03 / $170.18	Facility		$69.20	$138.03	$170.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.65 / $95.25 / $203.16	Facility		$50.65	$95.25	$203.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.62 / $123.99 / $192.17	Professional		$80.62	$123.99	$192.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.81 / $110.64 / $182.37	Professional		$58.81	$110.64	$182.37
United Facility/Professional Professional Modifier Low / Median / High Price $90.06 / $133.28 / $221.44	Professional		$90.06	$133.28	$221.44