Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.48 / $77.48 / $154.97	Facility		$77.48	$77.48	$154.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $72.17 / $95.26	Professional		$69.37	$72.17	$95.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.71 / $119.09 / $147.82	Facility		$63.71	$119.09	$147.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $69.37 / $76.45	Professional		$69.37	$69.37	$76.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.05 / $170.44 / $206.56	Professional		$135.05	$170.44	$206.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $69.37 / $77.48 / $146.35	Facility		$69.37	$77.48	$146.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $76.30 / $90.18	Professional		$69.37	$76.30	$90.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.08 / $86.10 / $208.11	Facility		$68.08	$86.10	$208.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.23 / $69.37 / $119.09	Facility		$25.23	$69.37	$119.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.23 / $72.53 / $89.98	Professional		$25.23	$72.53	$89.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $55.26 / $64.44 / $144.47	Facility		$55.26	$64.44	$144.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $69.37 / $83.24	Professional		$69.37	$69.37	$83.24
United Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $69.37 / $79.78	Professional		$69.37	$69.37	$79.78