Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $154.88 / $173.78	Facility		$54.95	$154.88	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $43.65 / $141.25	Professional		$20.89	$43.65	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $75.86 / $120.23	Facility		$50.12	$75.86	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $64.57 / $169.82	Professional		$27.54	$64.57	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $154.88	Professional		$93.33	$125.89	$154.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $60.26 / $100.00	Facility		$29.51	$60.26	$100.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $83.18 / $147.91	Professional		$39.81	$83.18	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $102.33 / $125.89	Facility		$46.77	$102.33	$125.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $57.54 / $104.71	Facility		$28.84	$57.54	$104.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $79.43 / $147.91	Professional		$41.69	$79.43	$147.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $144.54 / $251.19	Facility		$91.20	$144.54	$251.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $165.96	Professional		$64.57	$77.62	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $97.72	Facility		$67.61	$67.61	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $52.48 / $97.72	Professional		$29.51	$52.48	$97.72