Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.41 / $92.19 / $157.84	Facility		$51.41	$92.19	$157.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.55 / $79.70 / $108.38	Professional		$56.55	$79.70	$108.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.91 / $94.93 / $104.76	Facility		$55.91	$94.93	$104.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $78.92 / $85.62	Professional		$78.92	$78.92	$85.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.71 / $112.92 / $147.22	Professional		$50.71	$112.92	$147.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $78.92 / $112.86 / $169.68	Facility		$78.92	$112.86	$169.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $83.65 / $102.60	Professional		$78.92	$83.65	$102.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.41 / $78.92 / $154.22	Facility		$51.41	$78.92	$154.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $59.67 / $60.65 / $112.86	Facility		$59.67	$60.65	$112.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.61 / $78.92 / $93.06	Professional		$65.61	$78.92	$93.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $86.14 / $144.87 / $253.57	Facility		$86.14	$144.87	$253.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $78.92 / $78.92	Professional		$78.92	$78.92	$78.92
United Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $78.92 / $87.85	Professional		$78.92	$78.92	$87.85