Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $117.49	Professional		$54.95	$69.18	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $251.19 / $309.03	Professional		$89.13	$251.19	$309.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $87.10 / $125.89	Facility		$69.18	$87.10	$125.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $93.33 / $125.89	Professional		$87.10	$93.33	$125.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $112.20 / $125.89	Facility		$91.20	$112.20	$125.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $125.89	Professional		$104.71	$114.82	$125.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $100.00 / $158.49	Facility		$69.18	$100.00	$158.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $102.33 / $120.23	Professional		$54.95	$102.33	$120.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $162.18 / $446.68	Facility		$95.50	$162.18	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $128.82	Professional		$117.49	$128.82	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $87.10 / $251.19	Facility		$57.54	$87.10	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $57.54 / $109.65	Professional		$52.48	$57.54	$109.65