Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.48 / $69.45 / $109.42	Facility		$55.48	$69.45	$109.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $55.48 / $164.56	Professional		$54.71	$55.48	$164.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.61 / $79.17 / $113.66	Facility		$51.61	$79.17	$113.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $54.71 / $59.35	Professional		$54.71	$54.71	$59.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $122.16 / $147.22	Professional		$54.71	$122.16	$147.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.71 / $78.23 / $117.63	Facility		$54.71	$78.23	$117.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $60.18 / $71.12	Professional		$54.71	$60.18	$71.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $54.71 / $68.39 / $164.13	Facility		$54.71	$68.39	$164.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.71 / $79.17 / $117.63	Facility		$54.71	$79.17	$117.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.62 / $69.31 / $76.26	Professional		$58.62	$69.31	$76.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.72 / $92.12 / $201.61	Facility		$60.72	$92.12	$201.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $54.71 / $54.71	Professional		$54.71	$54.71	$54.71
United Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $54.71 / $54.71	Professional		$54.71	$54.71	$54.71