Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.83 / $77.83 / $77.83	Facility		$77.83	$77.83	$77.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.64 / $47.64 / $274.20	Professional		$47.64	$47.64	$274.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.23 / $64.23 / $64.23	Facility		$64.23	$64.23	$64.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $64.23 / $71.44	Professional		$54.60	$64.23	$71.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.25 / $71.14 / $249.54	Professional		$62.25	$71.14	$249.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.64 / $65.27 / $118.70	Facility		$47.64	$65.27	$118.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.59 / $86.34 / $93.38	Professional		$83.59	$86.34	$93.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $88.93 / $99.11 / $115.92	Facility		$88.93	$99.11	$115.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $90.10 / $109.43	Professional		$88.93	$90.10	$109.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.64 / $65.27 / $118.70	Facility		$47.64	$65.27	$118.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $83.61 / $106.58	Professional		$64.23	$83.61	$106.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.36 / $134.36 / $158.04	Facility		$134.36	$134.36	$158.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.12 / $91.12 / $91.12	Professional		$91.12	$91.12	$91.12
United Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $48.77 / $89.85	Professional		$46.76	$48.77	$89.85