Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.44 / $57.45 / $115.39	Facility		$52.44	$57.45	$115.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $48.79 / $88.42	Professional		$21.67	$48.79	$88.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.27 / $61.11 / $134.63	Professional		$30.27	$61.11	$134.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $63.68 / $131.88	Professional		$43.34	$63.68	$131.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $23.85 / $55.56 / $121.02	Facility		$23.85	$55.56	$121.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $76.59 / $121.61	Professional		$36.29	$76.59	$121.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.90 / $97.15 / $112.56	Facility		$46.90	$97.15	$112.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.98 / $58.11 / $132.15	Facility		$23.98	$58.11	$132.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.37 / $68.88 / $133.76	Professional		$44.37	$68.88	$133.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $92.64 / $121.58 / $151.21	Facility		$92.64	$121.58	$151.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.09 / $65.20 / $137.13	Professional		$42.09	$65.20	$137.13
United Facility/Professional Professional Modifier Low / Median / High Price $65.78 / $103.60 / $148.22	Professional		$65.78	$103.60	$148.22