Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $50.12	Professional		$30.20	$38.90	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $181.97 / $181.97	Professional		$69.18	$181.97	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $83.18 / $104.71	Professional		$70.79	$83.18	$104.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $45.71 / $85.11	Facility		$30.20	$45.71	$85.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $37.15 / $47.86	Professional		$30.20	$37.15	$47.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $57.54 / $77.62	Facility		$38.90	$57.54	$77.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $43.65 / $74.13	Facility		$30.20	$43.65	$74.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $181.97	Professional		$70.79	$79.43	$181.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $125.89 / $151.36	Facility		$93.33	$125.89	$151.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $112.20	Professional		$69.18	$89.13	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $141.25 / $186.21	Facility		$112.20	$141.25	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $95.50 / $134.90	Professional		$51.29	$95.50	$134.90