Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $79.43 / $131.83	Facility		$54.95	$79.43	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $54.95 / $70.79	Professional		$53.70	$54.95	$70.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $79.43 / $114.82	Facility		$51.29	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $58.88	Professional		$54.95	$54.95	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $117.49 / $141.25	Professional		$54.95	$117.49	$141.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $57.54 / $109.65	Facility		$54.95	$57.54	$109.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $60.26 / $70.79	Professional		$54.95	$60.26	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $67.61 / $114.82	Facility		$54.95	$67.61	$114.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $79.43 / $165.96	Facility		$54.95	$79.43	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $60.26 / $79.43	Professional		$54.95	$60.26	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $91.20 / $190.55	Facility		$60.26	$91.20	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $131.83	Facility		$54.95	$54.95	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $56.23	Professional		$54.95	$54.95	$56.23