Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.39 / $79.23 / $124.20	Facility		$63.39	$79.23	$124.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $63.96 / $110.30	Professional		$62.10	$63.96	$110.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $108.47 / $125.98	Facility		$58.58	$108.47	$125.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $73.23	Professional		$62.10	$62.10	$73.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.29 / $140.28 / $178.00	Professional		$106.29	$140.28	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $65.20 / $138.22	Facility		$62.10	$65.20	$138.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $67.70 / $80.73	Professional		$62.10	$67.70	$80.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.09 / $71.76 / $186.30	Facility		$62.09	$71.76	$186.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $70.06 / $133.52	Facility		$62.10	$70.06	$133.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $80.73 / $88.47	Professional		$62.99	$80.73	$88.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.70 / $109.07 / $249.12	Facility		$72.70	$109.07	$249.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $74.52	Professional		$62.10	$62.10	$74.52
United Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $71.42	Professional		$62.10	$62.10	$71.42