Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.62 / $49.62 / $116.76	Facility		$49.62	$49.62	$116.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $48.46 / $85.62	Professional		$48.46	$48.46	$85.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.24 / $99.24 / $99.24	Facility		$99.24	$99.24	$99.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.62 / $49.62 / $49.62	Professional		$49.62	$49.62	$49.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $49.73 / $59.56	Professional		$22.33	$49.73	$59.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $43.12 / $64.22 / $104.19	Facility		$43.12	$64.22	$104.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $17.88 / $17.88 / $41.43	Professional		$17.88	$17.88	$41.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $48.46 / $64.22 / $104.19	Facility		$48.46	$64.22	$104.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.17 / $51.78 / $60.81	Professional		$29.17	$51.78	$60.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $200.94 / $200.94 / $200.94	Facility		$200.94	$200.94	$200.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $49.62 / $49.62 / $49.62	Professional		$49.62	$49.62	$49.62
United Facility/Professional Professional Modifier Low / Median / High Price $48.65 / $48.65 / $55.95	Professional		$48.65	$48.65	$55.95