Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.97 / $81.84 / $122.88	Facility		$62.97	$81.84	$122.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $63.92 / $196.71	Professional		$61.44	$63.92	$196.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.96 / $107.08 / $125.84	Facility		$57.96	$107.08	$125.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $61.44 / $72.45	Professional		$61.44	$61.44	$72.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $105.74 / $138.85 / $178.00	Professional		$105.74	$138.85	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $65.08 / $136.77	Facility		$61.44	$65.08	$136.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $66.84 / $79.87	Professional		$61.44	$66.84	$79.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $76.80 / $184.32	Facility		$61.44	$76.80	$184.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $69.20 / $132.10	Facility		$61.44	$69.20	$132.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.92 / $79.73 / $88.70	Professional		$62.92	$79.73	$88.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.14 / $115.52 / $239.52	Facility		$72.14	$115.52	$239.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $61.44 / $73.73	Professional		$61.44	$61.44	$73.73
United Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $61.44 / $70.66	Professional		$61.44	$61.44	$70.66