Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.38 / $110.34 / $156.34	Facility		$46.38	$110.34	$156.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.43 / $51.55 / $117.44	Professional		$32.43	$51.55	$117.44
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $78.05 / $78.05 / $78.05	Professional	25	$78.05	$78.05	$78.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.04 / $110.62 / $180.93	Professional		$47.04	$110.62	$180.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $110.90 / $170.78	Professional		$69.84	$110.90	$170.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.67 / $53.43 / $112.05	Facility		$30.67	$53.43	$112.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.71 / $100.64 / $174.54	Professional		$61.71	$100.64	$174.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.85 / $89.08 / $145.38	Facility		$49.85	$89.08	$145.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.67 / $53.43 / $112.05	Facility		$30.67	$53.43	$112.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.36 / $82.56 / $155.53	Professional		$47.36	$82.56	$155.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $106.70 / $169.80	Professional		$68.06	$106.70	$169.80
United Facility/Professional Professional Modifier Low / Median / High Price $63.24 / $81.84 / $200.19	Professional		$63.24	$81.84	$200.19