Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $3,311.31 / $3,388.44	Facility		$724.44	$3,311.31	$3,388.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $575.44 / $891.25	Professional		$489.78	$575.44	$891.25
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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $870.96 / $1,071.52	Professional		$741.31	$870.96	$1,071.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,621.81 / $1,905.46	Professional		$758.58	$1,621.81	$1,905.46
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 $758.58 / $831.76 / $1,023.29	Professional		$758.58	$831.76	$1,023.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,047.13	Facility		$758.58	$758.58	$1,047.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $891.25 / $1,995.26	Facility		$446.68	$891.25	$1,995.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $794.33 / $933.25	Professional		$79.43	$794.33	$933.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $2,187.76 / $2,951.21	Facility		$1,122.02	$2,187.76	$2,951.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $676.08 / $891.25	Professional		$562.34	$676.08	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $1,202.26	Facility		$891.25	$891.25	$1,202.26
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $891.25	Professional		$316.23	$316.23	$891.25