Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,129.88 / $4,962.67 / $15,341.00	Facility		$1,129.88	$4,962.67	$15,341.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $454.94 / $688.74 / $1,630.92	Professional		$454.94	$688.74	$1,630.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.00 / $736.00 / $736.00	Facility		$736.00	$736.00	$736.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $582.50 / $972.91 / $1,483.63	Professional		$582.50	$972.91	$1,483.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $967.15 / $1,134.71 / $1,361.32	Professional		$967.15	$1,134.71	$1,361.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $681.96 / $918.41 / $1,213.80	Facility		$681.96	$918.41	$1,213.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $791.40 / $894.04 / $1,369.41	Professional		$791.40	$894.04	$1,369.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $693.80 / $954.09 / $1,040.51	Facility		$693.80	$954.09	$1,040.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $693.63 / $1,004.51 / $2,919.00	Facility		$693.63	$1,004.51	$2,919.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $861.56 / $1,033.13 / $1,419.26	Professional		$861.56	$1,033.13	$1,419.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,364.17 / $9,638.43 / $12,117.15	Facility		$6,364.17	$9,638.43	$12,117.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $944.51 / $1,212.11 / $1,629.10	Professional		$944.51	$1,212.11	$1,629.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00
United Facility/Professional Professional Modifier Low / Median / High Price $710.50 / $1,000.50 / $1,618.95	Professional		$710.50	$1,000.50	$1,618.95