Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $639.60 / $2,690.00 / $9,302.62	Facility		$639.60	$2,690.00	$9,302.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,690.00 / $2,690.00 / $2,690.00	Facility	50	$2,690.00	$2,690.00	$2,690.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.10 / $520.89 / $1,165.81	Professional		$225.10	$520.89	$1,165.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $597.12 / $967.94 / $1,311.83	Professional		$597.12	$967.94	$1,311.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $703.26 / $1,012.54 / $1,140.02	Professional		$703.26	$1,012.54	$1,140.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $595.29 / $878.03 / $1,328.18	Facility		$595.29	$878.03	$1,328.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $662.49 / $760.22 / $1,424.86	Professional		$662.49	$760.22	$1,424.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $539.67 / $823.99 / $893.78	Facility		$539.67	$823.99	$893.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $617.76 / $1,039.16 / $3,274.00	Facility		$617.76	$1,039.16	$3,274.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $760.92 / $1,025.70 / $1,311.83	Professional		$760.92	$1,025.70	$1,311.83
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 $813.07 / $1,094.55 / $1,399.37	Professional		$813.07	$1,094.55	$1,399.37
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 $647.70 / $1,028.52 / $1,406.48	Professional		$647.70	$1,028.52	$1,406.48