Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.57 / $119.28 / $299.83	Facility		$41.57	$119.28	$299.83
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $77.00 / $77.00 / $210.90	Facility	CO	$77.00	$77.00	$210.90
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $63.13 / $119.28 / $217.06	Facility	CQ	$63.13	$119.28	$217.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $40.28 / $211.65	Professional		$14.40	$40.28	$211.65
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $152.00 / $152.00 / $152.00	Professional	CO	$152.00	$152.00	$152.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $34.36 / $36.22 / $47.10	Professional	CQ	$34.36	$36.22	$47.10
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 $36.11 / $68.00 / $105.16	Professional		$36.11	$68.00	$105.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $78.73 / $90.84	Professional		$36.76	$78.73	$90.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.26 / $50.44 / $90.12	Facility		$30.26	$50.44	$90.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.84 / $58.84 / $82.86	Professional		$40.84	$58.84	$82.86
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $31.83 / $31.83 / $31.83	Professional	CQ	$31.83	$31.83	$31.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $45.14 / $66.33 / $75.04	Facility		$45.14	$66.33	$75.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $88.33 / $95.25 / $120.00	Facility		$88.33	$95.25	$120.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.65 / $69.30 / $100.38	Professional		$41.65	$69.30	$100.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $68.73 / $104.91 / $143.77	Facility		$68.73	$104.91	$143.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.63 / $45.14 / $101.20	Professional		$42.63	$45.14	$101.20
United Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $40.42 / $95.37	Professional		$35.09	$40.42	$95.37