Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.02 / $87.10	Professional		$30.20	$38.02	$87.10
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $109.65 / $109.65 / $109.65	Professional	22	$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.18 / $51.29 / $60.26	Professional	52	$28.18	$51.29	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $57.54 / $97.72	Professional		$35.48	$57.54	$97.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $66.07 / $87.10	Professional		$35.48	$66.07	$87.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $43.65 / $77.62	Facility		$30.90	$43.65	$77.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $53.70 / $83.18	Professional		$34.67	$53.70	$83.18
Moda Health Facility/Professional Professional Modifier 22 Low / Median / High Price $109.65 / $109.65 / $109.65	Professional	22	$109.65	$109.65	$109.65
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $28.18 / $43.65 / $60.26	Professional	52	$28.18	$43.65	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $72.44 / $77.62	Facility		$57.54	$72.44	$77.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $41.69 / $74.13	Facility		$30.90	$41.69	$74.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $70.79 / $89.13	Professional		$44.67	$70.79	$89.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $95.50	Professional		$38.02	$67.61	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $58.88 / $93.33	Professional		$35.48	$58.88	$93.33