Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $2,747.00 / $7,920.26	Facility		$988.00	$2,747.00	$7,920.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.88 / $649.41 / $1,414.89	Professional		$428.88	$649.41	$1,414.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $555.80 / $979.58 / $1,444.20	Professional		$555.80	$979.58	$1,444.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $975.95 / $1,166.40 / $1,336.58	Professional		$975.95	$1,166.40	$1,336.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $546.63 / $888.95 / $1,241.84	Facility		$546.63	$888.95	$1,241.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $775.71 / $882.67 / $1,361.69	Professional		$775.71	$882.67	$1,361.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $592.54 / $956.30 / $1,076.02	Facility		$592.54	$956.30	$1,076.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $570.00 / $888.95 / $1,388.40	Facility		$570.00	$888.95	$1,388.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $856.80 / $1,037.25 / $1,418.03	Professional		$856.80	$1,037.25	$1,418.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $890.90	Facility		$564.70	$724.26	$890.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $909.63 / $1,196.66 / $1,574.55	Professional		$909.63	$1,196.66	$1,574.55
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $707.52 / $1,065.80 / $1,683.10	Professional		$707.52	$1,065.80	$1,683.10