Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $13,690.00 / $41,657.49	Facility		$2,747.00	$13,690.00	$41,657.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,291.36 / $1,845.84 / $6,162.00	Professional		$1,291.36	$1,845.84	$6,162.00
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $299.92 / $571.87 / $946.33	Professional	AS	$299.92	$571.87	$946.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,735.46 / $2,788.77 / $4,270.82	Professional		$1,735.46	$2,788.77	$4,270.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,656.54 / $3,123.10 / $3,733.11	Professional		$2,656.54	$3,123.10	$3,733.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,017.64 / $2,719.98 / $3,567.24	Facility		$2,017.64	$2,719.98	$3,567.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,329.80 / $2,599.66 / $3,820.07	Professional		$2,329.80	$2,599.66	$3,820.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,033.93 / $2,754.27 / $2,909.81	Facility		$2,033.93	$2,754.27	$2,909.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,017.64 / $2,755.90 / $3,707.85	Facility		$2,017.64	$2,755.90	$3,707.85
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $550.28 / $550.28 / $550.28	Facility	80	$550.28	$550.28	$550.28
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	AS	$467.74	$467.74	$467.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,600.40 / $2,963.79 / $4,003.07	Professional		$2,600.40	$2,963.79	$4,003.07
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $366.97 / $398.09 / $565.46	Professional	AS	$366.97	$398.09	$565.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,843.42 / $39,705.31 / $69,764.42	Facility		$15,843.42	$39,705.31	$69,764.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,656.31 / $3,389.71 / $4,555.81	Professional		$2,656.31	$3,389.71	$4,555.81
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $25,540.00 / $33,178.00	Facility		$3,340.00	$25,540.00	$33,178.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,140.98 / $3,064.53 / $4,594.97	Professional		$2,140.98	$3,064.53	$4,594.97