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 $25.70 / $38.90 / $54.95	Professional		$25.70	$38.90	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $112.20 / $112.20	Professional		$47.86	$112.20	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $41.69 / $64.57	Professional		$33.88	$41.69	$64.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $43.65 / $79.43	Facility		$23.99	$43.65	$79.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.02 / $54.95	Professional		$26.92	$38.02	$54.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $36.31 / $51.29	Facility		$23.99	$36.31	$51.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $39.81 / $64.57	Facility		$23.99	$39.81	$64.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $79.43 / $112.20	Professional		$48.98	$79.43	$112.20
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 $51.29 / $72.44 / $97.72	Professional		$51.29	$72.44	$97.72
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 $48.98 / $93.33 / $128.82	Professional		$48.98	$93.33	$128.82