Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $117.49 / $70,794.58	Facility		$58.88	$117.49	$70,794.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $64.57 / $37,153.52	Professional		$58.88	$64.57	$37,153.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $83.18 / $114.82	Facility		$56.23	$83.18	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $64.57	Professional		$58.88	$58.88	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $128.82 / $151.36	Professional		$58.88	$128.82	$151.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $63.10 / $147.91	Facility		$58.88	$63.10	$147.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $63.10 / $93.33	Professional		$58.88	$63.10	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $74.13 / $123.03	Facility		$58.88	$74.13	$123.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $63.10 / $114.82	Facility		$61.66	$63.10	$114.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $64.57 / $79.43	Professional		$60.26	$64.57	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $67.61 / $177.83	Facility		$58.88	$67.61	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $141.25	Facility		$58.88	$58.88	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88