Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $836.48 / $1,008.00 / $1,344.00	Facility		$836.48	$1,008.00	$1,344.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $53.00 / $1,535.36	Professional		$38.00	$53.00	$1,535.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $765.00 / $975.00 / $1,290.00	Professional		$765.00	$975.00	$1,290.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $992.00 / $1,165.28 / $1,358.56	Professional		$992.00	$1,165.28	$1,358.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $4,346.00 / $4,845.79 / $5,085.88	Facility		$4,346.00	$4,845.79	$5,085.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $541.20 / $775.84 / $1,297.23	Professional		$541.20	$775.84	$1,297.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $704.00 / $832.00 / $1,204.00	Facility		$704.00	$832.00	$1,204.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,302.40 / $3,232.79 / $5,085.88	Facility		$1,302.40	$3,232.79	$5,085.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $880.00 / $1,008.00 / $1,304.00	Professional		$880.00	$1,008.00	$1,304.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $924.00 / $1,068.80 / $1,312.80	Professional		$924.00	$1,068.80	$1,312.80
United Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $65.00 / $82.50	Professional		$54.00	$65.00	$82.50