Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,077.08 / $5,649.00 / $15,341.00	Facility		$1,077.08	$5,649.00	$15,341.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $411.35 / $731.20 / $2,413.91	Professional		$411.35	$731.20	$2,413.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $594.92 / $1,064.33 / $1,416.07	Professional		$594.92	$1,064.33	$1,416.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $771.13 / $1,108.18 / $1,269.39	Professional		$771.13	$1,108.18	$1,269.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $525.82 / $936.08 / $1,572.08	Facility		$525.82	$936.08	$1,572.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $681.87 / $786.35 / $1,517.20	Professional		$681.87	$786.35	$1,517.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $585.96 / $832.14 / $964.80	Facility		$585.96	$832.14	$964.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $731.20 / $1,088.00 / $3,274.00	Facility		$731.20	$1,088.00	$3,274.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $768.90 / $1,120.85 / $1,416.07	Professional		$768.90	$1,120.85	$1,416.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,671.70 / $18,246.18 / $21,922.68	Facility		$13,671.70	$18,246.18	$21,922.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $890.57 / $1,181.52 / $1,510.56	Professional		$890.57	$1,181.52	$1,510.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,529.00 / $12,113.00	Facility		$1,981.00	$9,529.00	$12,113.00
United Facility/Professional Professional Modifier Low / Median / High Price $688.06 / $950.76 / $1,526.20	Professional		$688.06	$950.76	$1,526.20