Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $1,905.46	Facility		$416.87	$416.87	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $1,202.26	Facility		$676.08	$676.08	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $891.25 / $1,096.48	Professional		$416.87	$891.25	$1,096.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $457.09 / $588.84	Professional		$416.87	$457.09	$588.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $588.84	Facility		$416.87	$416.87	$588.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $588.84 / $1,047.13	Facility		$416.87	$588.84	$1,047.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $457.09 / $588.84	Professional		$79.43	$457.09	$588.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $912.01 / $1,621.81	Facility		$630.96	$912.01	$1,621.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $354.81 / $501.19	Professional		$331.13	$354.81	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $660.69	Facility		$501.19	$501.19	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $501.19	Professional		$173.78	$173.78	$501.19