Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.85 / $48.85 / $48.85	Facility		$48.85	$48.85	$48.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $52.75 / $135.85	Professional		$52.75	$52.75	$135.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.77 / $68.56 / $103.58	Facility		$49.77	$68.56	$103.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $52.75 / $62.21	Professional		$52.75	$52.75	$62.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.76 / $119.11 / $138.94	Professional		$95.76	$119.11	$138.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $48.85 / $52.75 / $111.47	Facility		$48.85	$52.75	$111.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $55.92 / $65.94	Professional		$52.75	$55.92	$65.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.29 / $52.75 / $109.49	Facility		$46.29	$52.75	$109.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $52.75 / $58.03 / $111.22	Facility		$52.75	$58.03	$111.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $57.56 / $62.21	Professional		$52.75	$57.56	$62.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $195.53 / $195.53 / $195.53	Facility		$195.53	$195.53	$195.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.11 / $52.75 / $52.75	Professional		$50.11	$52.75	$52.75
United Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $52.75 / $60.66	Professional		$52.75	$52.75	$60.66