Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.15 / $63.74 / $109.59	Facility		$54.15	$63.74	$109.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $29.77 / $127.91	Professional		$14.40	$29.77	$127.91
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 $41.78 / $72.00 / $120.05	Professional		$41.78	$72.00	$120.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $106.19 / $120.55	Professional		$91.02	$106.19	$120.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $59.19 / $97.89	Facility		$41.38	$59.19	$97.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.44 / $75.78 / $109.31	Professional		$51.44	$75.78	$109.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.33 / $78.09 / $95.81	Facility		$52.33	$78.09	$95.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.71 / $68.30 / $112.00	Facility		$41.71	$68.30	$112.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $80.40 / $123.70	Professional		$47.52	$80.40	$123.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $85.92 / $130.34 / $186.87	Facility		$85.92	$130.34	$186.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.61 / $80.80 / $131.56	Professional		$54.61	$80.80	$131.56
United Facility/Professional Professional Modifier Low / Median / High Price $38.45 / $50.53 / $118.48	Professional		$38.45	$50.53	$118.48