Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $79.43	Professional		$40.74	$57.54	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $120.23	Professional		$102.33	$102.33	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $38.02 / $138.04	Professional		$35.48	$38.02	$138.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $79.43 / $107.15	Facility		$36.31	$79.43	$107.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $95.50 / $128.82	Professional		$48.98	$95.50	$128.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $97.72 / $104.71	Facility		$81.28	$97.72	$104.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $79.43 / $109.65	Facility		$36.31	$79.43	$109.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $138.04	Professional		$70.79	$91.20	$138.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $85.11 / $91.20	Professional		$79.43	$85.11	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $109.65 / $158.49	Professional		$54.95	$109.65	$158.49