Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $120.23	Professional		$58.88	$79.43	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $281.84 / $354.81	Professional		$100.00	$281.84	$354.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $100.00 / $162.18	Facility		$79.43	$100.00	$162.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $107.15 / $144.54	Professional		$97.72	$107.15	$144.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $128.82 / $173.78	Facility		$104.71	$128.82	$173.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $173.78	Professional		$117.49	$131.83	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $114.82 / $173.78	Facility		$69.18	$114.82	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $141.25	Professional		$75.86	$114.82	$141.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $186.21 / $501.19	Facility		$109.65	$186.21	$501.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $147.91 / $147.91	Professional		$134.90	$147.91	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $87.10 / $288.40	Facility		$64.57	$87.10	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $66.07 / $125.89	Professional		$58.88	$66.07	$125.89