Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $162.18 / $194.98	Facility		$63.10	$162.18	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $213.80	Professional		$39.81	$57.54	$213.80
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	CQ	$69.18	$69.18	$69.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $100.00 / $114.82	Facility		$50.12	$100.00	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $181.97	Professional		$50.12	$70.79	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $173.78	Professional		$104.71	$141.25	$173.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $74.13 / $134.90	Facility		$53.70	$74.13	$134.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $112.20 / $165.96	Professional		$74.13	$112.20	$165.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $131.83 / $141.25	Facility		$89.13	$131.83	$141.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $69.18 / $131.83	Facility		$45.71	$69.18	$131.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $173.78	Professional		$67.61	$91.20	$173.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $154.88 / $275.42	Facility		$102.33	$154.88	$275.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $181.97	Professional		$70.79	$85.11	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $107.15	Facility		$74.13	$74.13	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $60.26 / $138.04	Professional		$53.70	$60.26	$138.04