Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $3,548.13 / $3,548.13	Facility		$776.25	$3,548.13	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $616.60 / $954.99	Professional		$524.81	$616.60	$954.99
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 $776.25 / $870.96 / $1,122.02	Professional		$776.25	$870.96	$1,122.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $1,122.02	Facility		$794.33	$794.33	$1,122.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,071.52 / $2,089.30	Facility		$602.56	$1,071.52	$2,089.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $870.96 / $1,122.02	Professional		$79.43	$870.96	$1,122.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,380.38 / $3,090.30	Facility		$1,202.26	$1,380.38	$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