Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $150.00	Facility		$63.75	$63.75	$150.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.25 / $62.25 / $63.75	Professional		$62.25	$62.25	$63.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Professional		$63.75	$63.75	$63.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,530.90 / $3,409.05 / $4,085.15	Professional		$1,530.90	$3,409.05	$4,085.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $62.25 / $89.02 / $166.84	Facility		$62.25	$89.02	$166.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $77.79 / $77.79 / $418.28	Professional		$77.79	$77.79	$418.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $237.29 / $79,999.20 / $79,999.20	Facility		$237.29	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.25 / $89.02 / $166.84	Facility		$62.25	$89.02	$166.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $71.88 / $4,080.00	Professional		$63.75	$71.88	$4,080.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $167.07 / $244.56 / $553.07	Facility		$167.07	$244.56	$553.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $183.95 / $183.95 / $183.95	Professional		$183.95	$183.95	$183.95
United Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $62.50	Professional		$62.50	$62.50	$62.50