Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.39 / $93.95 / $143.04	Facility		$73.39	$93.95	$143.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $77.73 / $171.22	Professional		$71.52	$77.73	$171.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.47 / $103.34 / $147.91	Facility		$67.47	$103.34	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $77.59	Professional		$71.52	$71.52	$77.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $161.22 / $192.34	Professional		$71.52	$161.22	$192.34
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $102.27 / $187.20	Facility		$71.52	$102.27	$187.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $75.81 / $92.98	Professional		$71.52	$75.81	$92.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $83.08 / $214.56	Facility		$71.52	$83.08	$214.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $103.34 / $187.20	Facility		$71.52	$103.34	$187.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.59 / $91.29 / $112.05	Professional		$77.59	$91.29	$112.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $421.69	Facility		$83.18	$83.18	$421.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $71.52	Professional		$71.52	$71.52	$71.52
United Facility/Professional Professional Modifier Low / Median / High Price $71.52 / $71.52 / $71.52	Professional		$71.52	$71.52	$71.52