Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.53 / $57.53 / $135.36	Facility		$57.53	$57.53	$135.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.17 / $56.17 / $57.53	Professional		$56.17	$56.17	$57.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.06 / $115.06 / $115.06	Facility		$115.06	$115.06	$115.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $57.53 / $57.53	Professional		$57.53	$57.53	$57.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $56.17 / $80.31 / $120.77	Facility		$56.17	$80.31	$120.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.81 / $79,999.20 / $79,999.20	Facility		$58.81	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.04 / $64.86 / $112.80	Facility		$62.04	$64.86	$112.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $70.50 / $70.50	Professional		$57.53	$70.50	$70.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.53 / $88.41 / $190.60	Facility		$57.53	$88.41	$190.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $57.53 / $57.53	Professional		$57.53	$57.53	$57.53
United Facility/Professional Professional Modifier Low / Median / High Price $56.40 / $56.40 / $56.40	Professional		$56.40	$56.40	$56.40