Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $79.43	Professional		$37.15	$51.29	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $186.21 / $234.42	Professional		$81.28	$186.21	$234.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $79.43 / $107.15	Facility		$63.10	$79.43	$107.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $85.11 / $114.82	Professional		$77.62	$85.11	$114.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $93.33 / $107.15	Facility		$85.11	$93.33	$107.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $107.15 / $107.15	Professional		$93.33	$107.15	$107.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $81.28 / $123.03	Facility		$52.48	$81.28	$123.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $93.33 / $112.20	Professional		$39.81	$93.33	$112.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $151.36 / $407.38	Facility		$89.13	$151.36	$407.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $120.23 / $120.23	Professional		$107.15	$120.23	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $87.10 / $186.21	Facility		$42.66	$87.10	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $42.66 / $83.18	Professional		$38.90	$42.66	$83.18