Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.23 / $72.23 / $77.62	Facility		$72.23	$72.23	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.78 / $61.82 / $90.30	Professional		$48.78	$61.82	$90.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.31 / $78.31 / $78.31	Facility		$78.31	$78.31	$78.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.95 / $55.95 / $55.95	Professional		$55.95	$55.95	$55.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.34 / $133.31 / $158.55	Professional		$111.34	$133.31	$158.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $59.71 / $91.33 / $161.28	Facility		$59.71	$91.33	$161.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $93.41 / $113.22 / $185.68	Professional		$93.41	$113.22	$185.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $76.94 / $123.28 / $127.30	Facility		$76.94	$123.28	$127.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $59.71 / $96.14 / $161.32	Facility		$59.71	$96.14	$161.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.86 / $133.85 / $169.42	Professional		$86.86	$133.85	$169.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.30 / $139.19 / $176.46	Professional		$95.30	$139.19	$176.46
United Facility/Professional Professional Modifier Low / Median / High Price $90.15 / $123.90 / $190.57	Professional		$90.15	$123.90	$190.57