Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.18 / $73.92 / $116.93	Facility		$58.18	$73.92	$116.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $67.20 / $134.16	Professional		$49.95	$67.20	$134.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.12 / $57.63 / $107.64	Facility		$47.12	$57.63	$107.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $54.19	Professional		$49.95	$49.95	$54.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $145.62 / $171.12	Professional		$49.95	$145.62	$171.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $43.52 / $71.43 / $107.39	Facility		$43.52	$71.43	$107.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $52.95 / $64.94	Professional		$49.95	$52.95	$64.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.95 / $71.15 / $139.47	Facility		$49.95	$71.15	$139.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.12 / $58.65 / $107.64	Facility		$47.12	$58.65	$107.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $54.44 / $95.26	Professional		$49.95	$54.44	$95.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $59.39 / $59.39 / $375.14	Facility		$59.39	$59.39	$375.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $49.95	Professional		$49.95	$49.95	$49.95
United Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $49.95	Professional		$49.95	$49.95	$49.95