Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.61 / $158.61 / $162.86	Facility		$158.61	$158.61	$162.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $57.69 / $208.10	Professional		$36.10	$57.69	$208.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.45 / $46.45 / $46.45	Facility		$46.45	$46.45	$46.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $33.90 / $46.45	Professional		$33.90	$33.90	$46.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $152.69 / $199.16	Professional		$67.31	$152.69	$199.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.69 / $76.36 / $96.16	Facility		$57.69	$76.36	$96.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $71.50 / $90.39 / $100.97	Professional		$71.50	$90.39	$100.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $76.34 / $86.54 / $96.16	Facility		$76.34	$86.54	$96.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $81.43 / $86.54 / $96.16	Professional		$81.43	$86.54	$96.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $46.45 / $81.97 / $100.97	Facility		$46.45	$81.97	$100.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $84.20 / $105.78	Professional		$33.90	$84.20	$105.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $80.12 / $159.91 / $337.36	Facility		$80.12	$159.91	$337.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $82.70 / $105.78 / $105.78	Professional		$82.70	$105.78	$105.78
United Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $35.97 / $68.65	Professional		$33.86	$35.97	$68.65