Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $21.38	Professional		$21.38	$21.38	$21.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $169.82	Professional		$97.72	$128.82	$169.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $58.88 / $77.62	Facility		$52.48	$58.88	$77.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $58.88 / $69.18	Professional		$52.48	$58.88	$69.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $58.88 / $61.66	Facility		$45.71	$58.88	$61.66
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $61.66 / $61.66	Professional		$54.95	$61.66	$61.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $58.88 / $85.11	Facility		$50.12	$58.88	$85.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $58.88 / $79.43	Professional		$21.38	$58.88	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $234.42	Facility		$58.88	$58.88	$234.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $69.18 / $69.18	Professional		$66.07	$69.18	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $100.00	Facility		$75.86	$75.86	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $35.48 / $58.88	Professional		$23.44	$35.48	$58.88