Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,368.25 / $2,368.25 / $4,132.50	Facility		$2,368.25	$2,368.25	$4,132.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $684.00 / $807.50 / $921.50	Professional		$684.00	$807.50	$921.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,543.75 / $2,377.38 / $2,760.23	Facility		$1,543.75	$2,377.38	$2,760.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $555.75 / $555.75 / $555.75	Professional		$555.75	$555.75	$555.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $950.00 / $2,085.91 / $2,499.61	Professional		$950.00	$2,085.91	$2,499.61
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $712.50 / $997.50 / $2,090.00	Facility		$712.50	$997.50	$2,090.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $950.00 / $950.00 / $1,330.00	Professional		$950.00	$950.00	$1,330.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $950.00 / $1,045.00 / $1,662.50	Facility		$950.00	$1,045.00	$1,662.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $921.50 / $1,258.75 / $2,377.38	Facility		$921.50	$1,258.75	$2,377.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $997.50 / $1,045.00 / $1,330.00	Professional		$997.50	$1,045.00	$1,330.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,852.50 / $2,890.85 / $3,729.61	Facility		$1,852.50	$2,890.85	$3,729.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,517.82 / $1,867.97 / $2,987.44	Professional		$1,517.82	$1,867.97	$2,987.44
United Facility/Professional Professional Modifier Low / Median / High Price $399.00 / $399.00 / $997.50	Professional		$399.00	$399.00	$997.50