Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $3,548.13 / $3,548.13	Facility		$758.58	$3,548.13	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $602.56 / $758.58	Professional		$489.78	$602.56	$758.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $2,290.87	Facility		$1,288.25	$1,288.25	$2,290.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,698.24 / $2,089.30	Professional		$794.33	$1,698.24	$2,089.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $933.25 / $1,096.48	Professional		$741.31	$933.25	$1,096.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $1,096.48	Facility		$794.33	$794.33	$1,096.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,071.52 / $1,995.26	Facility		$588.84	$1,071.52	$1,995.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $870.96 / $1,096.48	Professional		$79.43	$870.96	$1,096.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,290.87 / $3,090.30	Facility		$1,174.90	$2,290.87	$3,090.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $676.08 / $954.99	Professional		$630.96	$676.08	$954.99
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $1,258.93	Facility		$954.99	$954.99	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $954.99	Professional		$331.13	$331.13	$954.99