Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $418.24 / $504.00 / $672.00	Facility		$418.24	$504.00	$672.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $53.00 / $767.68	Professional		$38.00	$53.00	$767.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $357.00 / $455.00 / $602.00	Professional		$357.00	$455.00	$602.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $496.00 / $582.64 / $679.28	Professional		$496.00	$582.64	$679.28
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 $278.80 / $384.00 / $648.61	Professional		$278.80	$384.00	$648.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $352.00 / $416.00 / $602.00	Facility		$352.00	$416.00	$602.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $651.20 / $3,232.79 / $5,085.88	Facility		$651.20	$3,232.79	$5,085.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $413.00 / $500.00 / $640.00	Professional		$413.00	$500.00	$640.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $462.00 / $534.40 / $656.40	Professional		$462.00	$534.40	$656.40
United Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $65.25 / $94.00	Professional		$52.00	$65.25	$94.00