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 $52.48 / $67.61 / $107.15	Professional		$52.48	$67.61	$107.15
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 $102.33 / $245.47 / $309.03	Professional		$102.33	$245.47	$309.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $102.33 / $138.04	Facility		$81.28	$102.33	$138.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $107.15 / $147.91	Professional		$100.00	$107.15	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $114.82 / $134.90	Facility		$107.15	$114.82	$134.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $134.90	Professional		$114.82	$134.90	$134.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $109.65 / $169.82	Facility		$63.10	$109.65	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $117.49 / $141.25	Professional		$61.66	$117.49	$141.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $190.55 / $512.86	Facility		$112.20	$190.55	$512.86
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 $48.98 / $72.44 / $245.47	Facility		$48.98	$72.44	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $56.23 / $109.65	Professional		$51.29	$56.23	$109.65