Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,412.54 / $15,848.93	Facility		$1,000.00	$1,412.54	$15,848.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,549.93 / $14,791.08 / $16,595.87	Facility	50	$9,549.93	$14,791.08	$16,595.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $602.56 / $1,380.38	Professional		$467.74	$602.56	$1,380.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $691.83 / $1,023.29 / $3,162.28	Professional	50	$691.83	$1,023.29	$3,162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,071.52 / $1,621.81	Professional		$645.65	$1,071.52	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,148.15 / $1,513.56	Professional		$676.08	$1,148.15	$1,513.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $933.25 / $1,513.56	Facility		$562.34	$933.25	$1,513.56
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $9,549.93 / $14,791.08 / $16,595.87	Facility	50	$9,549.93	$14,791.08	$16,595.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,071.52 / $1,548.82	Professional		$812.83	$1,071.52	$1,548.82
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $380.19 / $794.33 / $2,630.27	Professional	50	$380.19	$794.33	$2,630.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,148.15 / $1,258.93	Facility		$870.96	$1,148.15	$1,258.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $891.25 / $1,348.96	Facility		$588.84	$891.25	$1,348.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $1,122.02 / $1,584.89	Professional		$79.43	$1,122.02	$1,584.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $5,888.44 / $7,244.36	Facility		$4,570.88	$5,888.44	$7,244.36
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $6,918.31 / $8,912.51 / $10,715.19	Facility	50	$6,918.31	$8,912.51	$10,715.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $1,659.59	Professional		$912.01	$1,230.27	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,754.40 / $8,912.51	Facility		$1,698.24	$5,754.40	$8,912.51
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,047.13 / $1,584.89	Professional		$707.95	$1,047.13	$1,584.89