Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $58.88 / $93.33	Professional		$46.77	$58.88	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $213.80 / $263.03	Professional		$83.18	$213.80	$263.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $81.28 / $114.82	Facility		$66.07	$81.28	$114.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $87.10 / $117.49	Professional		$81.28	$87.10	$117.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $107.15 / $112.20	Facility		$104.71	$107.15	$112.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $89.13 / $138.04	Facility		$57.54	$89.13	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $95.50 / $112.20	Professional		$74.13	$95.50	$112.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $151.36 / $416.87	Facility		$89.13	$151.36	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $120.23 / $120.23	Professional		$109.65	$120.23	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $162.18 / $213.80	Facility		$64.57	$162.18	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $48.98 / $93.33	Professional		$44.67	$48.98	$93.33