Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $495.96 / $854.73 / $1,187.50	Facility		$495.96	$854.73	$1,187.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $490.20 / $1,019.20	Professional		$416.78	$490.20	$1,019.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $677.28 / $677.28 / $1,210.97	Facility		$677.28	$677.28	$1,210.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $416.78	Professional		$416.78	$416.78	$416.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $914.76 / $1,096.20	Professional		$416.78	$914.76	$1,096.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $437.62 / $916.92	Facility		$416.78	$437.62	$916.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $562.65	Professional		$416.78	$416.78	$562.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $437.62 / $583.49	Facility		$416.78	$437.62	$583.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $552.23 / $1,015.09	Facility		$416.78	$552.23	$1,015.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $458.46 / $458.46 / $583.49	Professional		$458.46	$458.46	$583.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $812.72 / $1,268.26 / $1,721.88	Facility		$812.72	$1,268.26	$1,721.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $666.05 / $819.32 / $1,310.93	Professional		$666.05	$819.32	$1,310.93
United Facility/Professional Professional Modifier Low / Median / High Price $174.31 / $175.07 / $500.20	Professional		$174.31	$175.07	$500.20