Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $120.23 / $14,791.08	Facility		$30.20	$120.23	$14,791.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $31.62 / $6,025.60	Professional		$30.20	$31.62	$6,025.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $46.77 / $69.18	Facility		$24.55	$46.77	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $30.20 / $30.20	Professional		$28.18	$30.20	$30.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $63.10 / $75.86	Professional		$29.51	$63.10	$75.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $31.62 / $75.86	Facility		$30.20	$31.62	$75.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $60.26	Professional		$30.20	$33.11	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $36.31 / $60.26	Facility		$28.84	$36.31	$60.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $69.18	Facility		$30.20	$30.20	$69.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $79.43	Professional		$31.62	$31.62	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $77.62 / $144.54	Facility		$43.65	$77.62	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $72.44	Facility		$30.20	$30.20	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $42.66	Professional		$30.20	$34.67	$42.66