Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $112.20	Professional		$47.86	$69.18	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $147.91 / $181.97	Professional		$52.48	$147.91	$181.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $95.50 / $97.72	Facility		$54.95	$95.50	$97.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $79.43 / $102.33	Professional		$63.10	$79.43	$102.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $69.18 / $107.15	Facility		$67.61	$69.18	$107.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $70.79 / $134.90	Facility		$50.12	$70.79	$134.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $102.33	Professional		$61.66	$75.86	$102.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $181.97 / $295.12	Facility		$67.61	$181.97	$295.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $77.62 / $112.20	Professional		$70.79	$77.62	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $151.36 / $204.17	Facility		$54.95	$151.36	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $87.10	Professional		$39.81	$54.95	$87.10