Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.95 / $49.92 / $153.16	Facility		$29.95	$49.92	$153.16
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $32.36 / $111.15 / $282.97	Facility	CQ	$32.36	$111.15	$282.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.30 / $41.05 / $127.00	Professional		$14.30	$41.05	$127.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $18.84 / $37.97 / $106.64	Professional	CQ	$18.84	$37.97	$106.64
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 $27.00 / $56.00 / $98.37	Professional		$27.00	$56.00	$98.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $61.85 / $71.34	Professional		$28.58	$61.85	$71.34
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $22.62 / $38.65 / $77.81	Facility		$22.62	$38.65	$77.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $32.85 / $46.40 / $64.66	Professional		$32.85	$46.40	$64.66
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $24.17 / $28.01 / $32.79	Professional	CQ	$24.17	$28.01	$32.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.18 / $53.45 / $56.95	Facility		$40.18	$53.45	$56.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.23 / $90.00 / $120.00	Facility		$64.23	$90.00	$120.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $52.01 / $79.80	Professional		$32.00	$52.01	$79.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $49.09 / $72.81 / $105.84	Facility		$49.09	$72.81	$105.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $32.94 / $73.69	Professional		$27.60	$32.94	$73.69
United Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $28.87 / $67.69	Professional		$25.98	$28.87	$67.69