Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.43 / $63.51 / $112.20	Facility		$57.43	$63.51	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $57.43 / $69.61	Professional		$56.10	$57.43	$69.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.93 / $73.61 / $103.96	Facility		$52.93	$73.61	$103.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $56.10 / $60.86	Professional		$56.10	$56.10	$60.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $126.42 / $146.44	Professional		$56.10	$126.42	$146.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $56.10 / $80.22 / $120.62	Facility		$56.10	$80.22	$120.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $59.47 / $72.93	Professional		$56.10	$59.47	$72.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $56.10 / $65.02 / $168.30	Facility		$56.10	$65.02	$168.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.10 / $79.79 / $153.97	Facility		$56.10	$79.79	$153.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $64.03 / $66.16	Professional		$56.10	$64.03	$66.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $49.90 / $82.38 / $186.30	Facility		$49.90	$82.38	$186.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $56.10 / $56.10	Professional		$56.10	$56.10	$56.10
United Facility/Professional Facility Modifier Low / Median / High Price $115.01 / $115.01 / $134.63	Facility		$115.01	$115.01	$134.63
United Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $56.10 / $56.10	Professional		$56.10	$56.10	$56.10