Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.55 / $54.55 / $128.36	Facility		$54.55	$54.55	$128.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.27 / $53.27 / $54.55	Professional		$53.27	$53.27	$54.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.10 / $109.10 / $109.10	Facility		$109.10	$109.10	$109.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $54.55 / $54.55	Professional		$54.55	$54.55	$54.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $41.12 / $70.59 / $114.53	Facility		$41.12	$70.59	$114.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.87 / $30.87 / $57.58	Professional		$30.87	$30.87	$57.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.15 / $79,999.20 / $79,999.20	Facility		$66.15	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.27 / $70.59 / $114.53	Facility		$53.27	$70.59	$114.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.84 / $57.58 / $70.53	Professional		$32.84	$57.58	$70.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $50.44 / $113.64 / $218.44	Facility		$50.44	$113.64	$218.44
United Facility/Professional Professional Modifier Low / Median / High Price $56.42 / $56.42 / $56.42	Professional		$56.42	$56.42	$56.42