Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $4,265.80 / $4,265.80	Facility		$912.01	$4,265.80	$4,265.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $724.44 / $1,148.15	Professional		$630.96	$724.44	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $2,754.23	Facility		$1,548.82	$1,548.82	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $954.99 / $1,348.96	Professional		$758.58	$954.99	$1,348.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $2,041.74 / $2,454.71	Professional		$954.99	$2,041.74	$2,454.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,047.13 / $1,380.38	Professional		$954.99	$1,047.13	$1,380.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,047.13 / $1,479.11	Facility		$851.14	$1,047.13	$1,479.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,318.26 / $2,754.23	Facility		$912.01	$1,318.26	$2,754.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $954.99 / $1,174.90	Professional		$79.43	$954.99	$1,174.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,818.38 / $3,715.35	Facility		$1,659.59	$2,818.38	$3,715.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $870.96 / $1,148.15	Professional		$707.95	$870.96	$1,148.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,513.56	Facility		$1,148.15	$1,148.15	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $1,148.15	Professional		$398.11	$398.11	$1,148.15