Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.09 / $61.09 / $61.09	Facility		$61.09	$61.09	$61.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $38.20 / $218.71	Professional		$38.00	$38.20	$218.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.69 / $48.69 / $48.69	Facility		$48.69	$48.69	$48.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $48.69 / $58.12	Professional		$41.39	$48.69	$58.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.38 / $63.49 / $195.86	Professional		$49.38	$63.49	$195.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.00 / $79.56 / $95.84	Facility		$38.00	$79.56	$95.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $7.78 / $68.25 / $91.05	Professional		$7.78	$68.25	$91.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $70.54 / $85.35 / $93.59	Facility		$70.54	$85.35	$93.59
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $70.54 / $77.59 / $87.93	Professional		$70.54	$77.59	$87.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.95 / $67.04 / $111.11	Facility		$30.95	$67.04	$111.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.69 / $66.69 / $84.09	Professional		$48.69	$66.69	$84.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $107.17 / $107.17 / $126.06	Facility		$107.17	$107.17	$126.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.67 / $72.67 / $72.67	Professional		$72.67	$72.67	$72.67
United Facility/Professional Professional Modifier Low / Median / High Price $36.77 / $44.70 / $70.64	Professional		$36.77	$44.70	$70.64