Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.44 / $152.94 / $300.12	Facility		$33.44	$152.94	$300.12
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $89.11 / $89.11 / $228.00	Facility	CO	$89.11	$89.11	$228.00
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $41.54 / $89.31 / $396.72	Facility	CQ	$41.54	$89.31	$396.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.04 / $38.06 / $131.33	Professional		$14.04	$38.06	$131.33
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $21.22 / $47.45 / $82.14	Professional	CQ	$21.22	$47.45	$82.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $108.00 / $120.00	Facility		$75.00	$108.00	$120.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.51 / $58.06 / $100.72	Professional		$28.51	$58.06	$100.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.31 / $65.59 / $75.62	Professional		$30.31	$65.59	$75.62
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $24.21 / $42.63 / $83.24	Facility		$24.21	$42.63	$83.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $34.32 / $50.38 / $68.52	Professional		$34.32	$50.38	$68.52
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $27.03 / $29.71 / $35.03	Professional	CQ	$27.03	$29.71	$35.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.15 / $58.29 / $61.64	Facility		$39.15	$58.29	$61.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.86 / $90.00 / $120.00	Facility		$69.86	$90.00	$120.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.25 / $56.51 / $84.71	Professional		$34.25	$56.51	$84.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $53.39 / $79.36 / $114.99	Facility		$53.39	$79.36	$114.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $30.02 / $35.79 / $80.06	Professional		$30.02	$35.79	$80.06
United Facility/Professional Professional Modifier Low / Median / High Price $28.26 / $31.40 / $74.09	Professional		$28.26	$31.40	$74.09