Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $3,388.44 / $3,388.44	Facility		$741.31	$3,388.44	$3,388.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $588.84 / $912.01	Professional		$501.19	$588.84	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $2,187.76	Facility		$1,230.27	$1,230.27	$2,187.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,621.81 / $1,995.26	Professional		$758.58	$1,621.81	$1,995.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $831.76 / $1,071.52	Professional		$741.31	$831.76	$1,071.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,071.52	Facility		$758.58	$758.58	$1,071.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,047.13 / $1,995.26	Facility		$575.44	$1,047.13	$1,995.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $831.76 / $1,071.52	Professional		$79.43	$831.76	$1,071.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $2,238.72 / $2,951.21	Facility		$1,148.15	$2,238.72	$2,951.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $645.65 / $912.01	Professional		$602.56	$645.65	$912.01
United Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $1,202.26	Facility		$912.01	$912.01	$1,202.26
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $912.01	Professional		$316.23	$316.23	$912.01