Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.64 / $478.64 / $1,670.40	Facility		$478.64	$478.64	$1,670.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.24 / $163.19 / $186.24	Professional		$138.24	$163.19	$186.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $624.00 / $624.00 / $1,115.71	Facility		$624.00	$624.00	$1,115.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $384.00 / $843.03 / $1,010.23	Professional		$384.00	$843.03	$1,010.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $180.48 / $266.32 / $489.70	Facility		$180.48	$266.32	$489.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $384.00 / $460.80 / $537.60	Professional		$384.00	$460.80	$537.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $384.00 / $384.00 / $537.60	Facility		$384.00	$384.00	$537.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $186.24 / $266.32 / $844.80	Facility		$186.24	$266.32	$844.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $211.20 / $230.40 / $460.80	Professional		$211.20	$230.40	$460.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $384.00 / $1,133.53 / $1,507.47	Facility		$384.00	$1,133.53	$1,507.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $613.52 / $645.80 / $1,207.55	Professional		$613.52	$645.80	$1,207.55
United Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $80.64 / $345.60	Professional		$80.64	$80.64	$345.60