Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Facility		$51.29	$51.29	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $69.18 / $104.71	Professional		$45.71	$69.18	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Professional		$45.71	$45.71	$45.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $120.23 / $151.36	Professional		$97.72	$120.23	$151.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $87.10 / $173.78	Facility		$50.12	$87.10	$173.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $79.43 / $104.71	Professional		$46.77	$79.43	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $109.65 / $112.20	Facility		$91.20	$109.65	$112.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $83.18 / $134.90	Facility		$51.29	$83.18	$134.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $109.65	Professional		$47.86	$47.86	$109.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $151.36	Professional		$87.10	$114.82	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $107.15 / $165.96	Professional		$63.10	$107.15	$165.96