Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.60 / $47.76 / $53.81	Facility		$29.60	$47.76	$53.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $24.12 / $53.81	Professional		$23.88	$24.12	$53.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.53 / $60.82 / $103.28	Facility		$22.53	$60.82	$103.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $23.88 / $29.28	Professional		$23.88	$23.88	$29.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.89 / $68.94 / $170.00	Professional		$49.89	$68.94	$170.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $23.88 / $41.79 / $281.54	Facility		$23.88	$41.79	$281.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $27.46 / $64.47	Professional		$23.88	$27.46	$64.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $23.88 / $32.24 / $96.40	Facility		$23.88	$32.24	$96.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.88 / $51.74 / $121.76	Facility		$23.88	$51.74	$121.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.90 / $51.74 / $76.03	Professional		$25.90	$51.74	$76.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $31.97 / $53.69 / $121.24	Facility		$31.97	$53.69	$121.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $23.88 / $26.27	Professional		$23.88	$23.88	$26.27
United Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $23.88 / $27.46	Professional		$23.88	$23.88	$27.46