Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.26 / $78.00 / $139.11	Facility		$57.26	$78.00	$139.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $50.08 / $100.63	Professional		$30.40	$50.08	$100.63
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $42.71 / $55.52 / $67.55	Professional	25	$42.71	$55.52	$67.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.20 / $101.89 / $163.79	Professional		$48.20	$101.89	$163.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.29 / $104.91 / $145.27	Professional		$68.29	$104.91	$145.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $37.93 / $49.75 / $100.43	Facility		$37.93	$49.75	$100.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.49 / $98.61 / $159.22	Professional		$56.49	$98.61	$159.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $55.86 / $96.92 / $125.96	Facility		$55.86	$96.92	$125.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $37.93 / $49.75 / $100.43	Facility		$37.93	$49.75	$100.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.17 / $77.22 / $144.22	Professional		$49.17	$77.22	$144.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $206.91 / $259.19 / $333.69	Facility		$206.91	$259.19	$333.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.25 / $93.53 / $149.68	Professional		$61.25	$93.53	$149.68
United Facility/Professional Professional Modifier Low / Median / High Price $58.49 / $79.44 / $174.31	Professional		$58.49	$79.44	$174.31