Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $51.31 / $159.11	Facility		$51.31	$51.31	$159.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $56.44	Professional		$51.31	$51.31	$56.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.38 / $83.38 / $149.07	Facility		$83.38	$83.38	$149.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $51.31	Professional		$51.31	$51.31	$51.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $112.92 / $135.32	Professional		$51.31	$112.92	$135.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $61.57 / $124.50	Facility		$51.31	$61.57	$124.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $69.27	Professional		$51.31	$51.31	$69.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $51.31 / $71.83	Facility		$51.31	$51.31	$71.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $65.16 / $124.50	Facility		$51.31	$65.16	$124.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $56.44 / $71.83	Professional		$51.31	$56.44	$71.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $87.14 / $141.63 / $201.43	Facility		$87.14	$141.63	$201.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.77 / $100.71 / $160.94	Professional		$81.77	$100.71	$160.94
United Facility/Professional Professional Modifier Low / Median / High Price $21.55 / $21.55 / $51.33	Professional		$21.55	$21.55	$51.33