Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $20.89 / $34.67	Facility		$14.13	$20.89	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $18.62	Professional		$14.13	$14.13	$18.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $23.99 / $27.54	Facility		$13.49	$23.99	$27.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $16.22	Professional		$14.13	$14.13	$16.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $30.90 / $37.15	Professional		$22.39	$30.90	$37.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $15.49 / $28.18	Facility		$14.13	$15.49	$28.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $15.14 / $21.88	Professional		$14.13	$15.14	$21.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $14.45 / $22.91	Facility		$13.80	$14.45	$22.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.79 / $26.92	Facility		$14.13	$14.79	$26.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $17.38 / $79.43	Professional		$14.13	$17.38	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $21.88 / $42.66	Facility		$12.88	$21.88	$42.66
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $15.49	Professional		$14.13	$14.13	$15.49
United Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.13 / $33.88	Facility		$14.13	$14.13	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $15.85	Professional		$14.13	$14.13	$15.85