Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $72.44 / $117.49	Facility		$51.29	$72.44	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $72.44	Professional		$57.54	$57.54	$72.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $64.57 / $85.11	Facility		$54.95	$64.57	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $63.10	Professional		$57.54	$57.54	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $85.11 / $100.00	Professional		$38.90	$85.11	$100.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $61.66 / $269.15	Facility		$57.54	$61.66	$269.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $177.83	Professional		$57.54	$64.57	$177.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $48.98 / $81.28	Facility		$39.81	$48.98	$81.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $85.11 / $177.83	Facility		$57.54	$85.11	$177.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $63.10 / $134.90	Professional		$46.77	$63.10	$134.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54