Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $81.28 / $144.54	Professional		$61.66	$81.28	$144.54
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 $104.71 / $295.12 / $363.08	Professional		$104.71	$295.12	$363.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $102.33 / $151.36	Facility		$81.28	$102.33	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $109.65 / $147.91	Professional		$100.00	$109.65	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $131.83 / $134.90	Facility		$107.15	$131.83	$134.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $117.49 / $181.97	Facility		$79.43	$117.49	$181.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $120.23 / $141.25	Professional		$61.66	$120.23	$141.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $190.55 / $524.81	Facility		$114.82	$190.55	$524.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $151.36 / $151.36	Professional		$138.04	$151.36	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $75.86 / $295.12	Facility		$60.26	$75.86	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $67.61 / $128.82	Professional		$61.66	$67.61	$128.82