Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $695.52 / $753.05 / $1,794.89	Facility		$695.52	$753.05	$1,794.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.60 / $292.60 / $698.40	Professional		$292.60	$292.60	$698.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,170.00 / $1,170.00 / $2,091.96	Facility		$1,170.00	$1,170.00	$2,091.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.20 / $421.20 / $421.20	Professional		$421.20	$421.20	$421.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $720.00 / $1,580.93 / $1,894.50	Professional		$720.00	$1,580.93	$1,894.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $756.00 / $1,584.00	Facility		$540.00	$756.00	$1,584.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $720.00 / $792.00 / $1,008.00	Professional		$720.00	$792.00	$1,008.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $792.00 / $1,260.00	Facility		$720.00	$792.00	$1,260.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $698.40 / $954.00 / $1,747.98	Facility		$698.40	$954.00	$1,747.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $756.00 / $792.00 / $1,008.00	Professional		$756.00	$792.00	$1,008.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,440.00 / $2,190.96 / $2,826.65	Facility		$1,440.00	$2,190.96	$2,826.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,150.69 / $1,416.12 / $2,264.82	Professional		$1,150.69	$1,416.12	$2,264.82
United Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $756.00	Professional		$302.39	$302.39	$756.00