Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.77 / $129.91 / $203.81	Facility		$67.77	$129.91	$203.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.10 / $55.10 / $122.40	Professional		$55.10	$55.10	$122.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.84 / $112.84 / $112.84	Facility		$112.84	$112.84	$112.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.42 / $56.42 / $56.42	Professional		$56.42	$56.42	$56.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $122.28 / $145.53	Professional		$106.00	$122.28	$145.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $55.10 / $73.02 / $118.47	Facility		$55.10	$73.02	$118.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $55.10 / $78.83 / $126.12	Facility		$55.10	$78.83	$126.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.42 / $78.83 / $110.36	Professional		$56.42	$78.83	$110.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.06 / $63.06 / $63.06	Professional		$63.06	$63.06	$63.06
United Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $56.50 / $64.98	Professional		$56.50	$56.50	$64.98