Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $5,623.41 / $5,754.40	Facility		$1,230.27	$5,623.41	$5,754.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $977.24 / $1,584.89	Professional		$831.76	$977.24	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $3,630.78	Facility		$2,041.74	$2,041.74	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,691.53 / $3,311.31	Professional		$1,258.93	$2,691.53	$3,311.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,380.38 / $1,778.28	Professional		$1,230.27	$1,380.38	$1,778.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,778.28	Facility		$1,258.93	$1,258.93	$1,778.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,698.24 / $3,311.31	Facility		$891.25	$1,698.24	$3,311.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $1,380.38 / $1,778.28	Professional		$79.43	$1,380.38	$1,778.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,801.89 / $5,011.87	Facility		$1,905.46	$3,801.89	$5,011.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,071.52 / $1,513.56	Professional		$1,000.00	$1,071.52	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $2,041.74	Facility		$1,513.56	$1,513.56	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $1,513.56	Professional		$524.81	$524.81	$1,513.56