Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.75 / $42.75 / $42.75	Facility		$42.75	$42.75	$42.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.35 / $37.35 / $37.35	Professional		$37.35	$37.35	$37.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.50 / $76.50 / $76.50	Facility		$76.50	$76.50	$76.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $38.25 / $38.25	Professional		$38.25	$38.25	$38.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.06 / $94.65 / $102.12	Professional		$82.06	$94.65	$102.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $37.35 / $49.50 / $80.30	Facility		$37.35	$49.50	$80.30
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 $37.35 / $53.44 / $85.50	Facility		$37.35	$53.44	$85.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $53.44 / $152.47	Professional		$38.25	$53.44	$152.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $42.75 / $42.75	Professional		$42.75	$42.75	$42.75
United Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $37.50 / $43.13	Professional		$37.50	$37.50	$43.13