Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $112.20	Professional		$52.48	$70.79	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Professional		$70.79	$70.79	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $257.04 / $316.23	Professional		$97.72	$257.04	$316.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $95.50 / $107.15	Facility		$77.62	$95.50	$107.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $102.33 / $138.04	Professional		$95.50	$102.33	$138.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $117.49 / $128.82	Facility		$100.00	$117.49	$128.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $128.82	Professional		$117.49	$128.82	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $107.15 / $165.96	Facility		$63.10	$107.15	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $112.20 / $134.90	Professional		$70.79	$112.20	$134.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $181.97 / $489.78	Facility		$107.15	$181.97	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $144.54 / $144.54	Professional		$128.82	$144.54	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $79.43 / $257.04	Facility		$72.44	$79.43	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $58.88 / $112.20	Professional		$52.48	$58.88	$112.20