Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.68 / $292.66 / $926.20	Facility		$95.68	$292.66	$926.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $47.16 / $316.27	Professional		$40.65	$47.16	$316.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.35 / $58.88 / $163.92	Facility		$38.35	$58.88	$163.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $47.94	Professional		$40.65	$40.65	$47.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.89 / $95.25 / $119.48	Professional		$83.89	$95.25	$119.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $61.35 / $129.19	Facility		$40.65	$61.35	$129.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $44.11 / $52.85	Professional		$40.65	$44.11	$52.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $46.64 / $121.95	Facility		$40.65	$46.64	$121.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $53.34 / $129.19	Facility		$40.65	$53.34	$129.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $52.01 / $57.31	Professional		$40.65	$52.01	$57.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $40.65	Professional		$40.65	$40.65	$40.65
United Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $46.75	Professional		$40.65	$40.65	$46.75