Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $7,920.26 / $20,400.00	Facility		$2,747.00	$7,920.26	$20,400.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,272.74 / $1,390.54 / $1,547.52	Facility	52	$1,272.74	$1,390.54	$1,547.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $999.90 / $1,290.17 / $3,129.47	Professional		$999.90	$1,290.17	$3,129.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,542.75 / $2,451.58 / $3,606.66	Professional		$1,542.75	$2,451.58	$3,606.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,013.05 / $2,488.86 / $2,995.20	Professional		$2,013.05	$2,488.86	$2,995.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,509.18 / $2,067.58 / $3,474.70	Facility		$1,509.18	$2,067.58	$3,474.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,034.53 / $2,293.46 / $3,259.61	Professional		$2,034.53	$2,293.46	$3,259.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,711.80 / $2,452.26 / $2,687.37	Facility		$1,711.80	$2,452.26	$2,687.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,639.69 / $2,748.00 / $5,852.00	Facility		$1,639.69	$2,748.00	$5,852.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $484.24 / $484.24 / $484.24	Facility	80	$484.24	$484.24	$484.24
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $411.61 / $411.61 / $411.61	Facility	AS	$411.61	$411.61	$411.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,055.17 / $2,472.30 / $3,539.10	Professional		$2,055.17	$2,472.30	$3,539.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,391.79 / $11,115.96 / $14,408.62	Facility		$8,391.79	$11,115.96	$14,408.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,329.12 / $2,842.67 / $4,036.18	Professional		$2,329.12	$2,842.67	$4,036.18
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,734.30 / $2,517.48 / $3,868.75	Professional		$1,734.30	$2,517.48	$3,868.75