Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $75.86 / $125.89	Facility		$53.70	$75.86	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $53.70 / $74.13	Professional		$52.48	$53.70	$74.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $83.18 / $97.72	Facility		$51.29	$83.18	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $60.26	Professional		$53.70	$53.70	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $134.90	Professional		$81.28	$112.20	$134.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $57.54 / $107.15	Facility		$53.70	$57.54	$107.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $57.54 / $75.86	Professional		$48.98	$57.54	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $52.48 / $83.18	Facility		$47.86	$52.48	$83.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $56.23 / $97.72	Facility		$53.70	$56.23	$97.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $79.43	Professional		$53.70	$61.66	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $77.62 / $147.91	Facility		$43.65	$77.62	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $58.88	Professional		$53.70	$53.70	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $128.82	Facility		$53.70	$53.70	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $60.26	Professional		$53.70	$53.70	$60.26