Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $102.33	Professional		$43.65	$63.10	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $218.78 / $269.15	Professional		$87.10	$218.78	$269.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $87.10 / $117.49	Facility		$69.18	$87.10	$117.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $93.33 / $125.89	Professional		$85.11	$93.33	$125.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $102.33 / $114.82	Facility		$91.20	$102.33	$114.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $114.82 / $114.82	Professional		$102.33	$114.82	$114.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $93.33 / $147.91	Facility		$57.54	$93.33	$147.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $100.00 / $120.23	Professional		$63.10	$100.00	$120.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $162.18 / $436.52	Facility		$95.50	$162.18	$436.52
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 $50.12 / $69.18 / $218.78	Facility		$50.12	$69.18	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $50.12 / $95.50	Professional		$45.71	$50.12	$95.50