Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.34 / $66.34 / $66.34	Facility		$66.34	$66.34	$66.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $76.42	Professional		$65.88	$65.88	$76.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.15 / $90.63 / $129.50	Facility		$62.15	$90.63	$129.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $77.69	Professional		$65.88	$65.88	$77.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.38 / $161.69 / $183.40	Professional		$131.38	$161.69	$183.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $66.34 / $198.00	Facility		$65.88	$66.34	$198.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $69.83 / $85.64	Professional		$65.88	$69.83	$85.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $68.43 / $137.03	Facility		$65.88	$68.43	$137.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $80.06 / $187.50	Facility		$65.88	$80.06	$187.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $82.75 / $187.50	Professional		$65.88	$82.75	$187.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.59 / $65.88 / $65.88	Professional		$62.59	$65.88	$65.88
United Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $75.76	Professional		$65.88	$65.88	$75.76