Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $85.11	Professional		$40.74	$53.70	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $194.98 / $251.19	Professional		$89.13	$194.98	$251.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $91.20 / $123.03	Facility		$72.44	$91.20	$123.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $95.50 / $131.83	Professional		$89.13	$95.50	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $95.50 / $120.23	Facility		$87.10	$95.50	$120.23
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $120.23 / $120.23	Professional		$91.20	$120.23	$120.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $91.20 / $134.90	Facility		$50.12	$91.20	$134.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $104.71 / $125.89	Professional		$43.65	$104.71	$125.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $169.82 / $457.09	Facility		$100.00	$169.82	$457.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $134.90 / $134.90	Professional		$123.03	$134.90	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $61.66 / $194.98	Facility		$56.23	$61.66	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $44.67 / $85.11	Professional		$40.74	$44.67	$85.11