Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $4,684.68 / $8,728.00	Facility		$988.00	$4,684.68	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.77 / $772.18 / $1,918.00	Professional		$420.77	$772.18	$1,918.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $683.04 / $1,207.16 / $1,643.23	Professional		$683.04	$1,207.16	$1,643.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $895.43 / $1,291.86 / $1,459.72	Professional		$895.43	$1,291.86	$1,459.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $675.64 / $1,028.81 / $1,660.19	Facility		$675.64	$1,028.81	$1,660.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $759.90 / $925.29 / $1,793.04	Professional		$759.90	$925.29	$1,793.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $653.40 / $952.74 / $1,119.57	Facility		$653.40	$952.74	$1,119.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $772.18 / $1,208.70 / $2,724.00	Facility		$772.18	$1,208.70	$2,724.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $884.29 / $1,279.20 / $1,635.90	Professional		$884.29	$1,279.20	$1,635.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,539.09 / $11,131.60 / $14,269.30	Facility		$8,539.09	$11,131.60	$14,269.30
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $12,808.64 / $16,697.40 / $21,403.95	Facility	50	$12,808.64	$16,697.40	$21,403.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,022.18 / $1,371.06 / $1,752.88	Professional		$1,022.18	$1,371.06	$1,752.88
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 $764.79 / $1,203.46 / $1,768.21	Professional		$764.79	$1,203.46	$1,768.21