Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,141.04 / $7,920.26 / $20,400.00	Facility		$1,141.04	$7,920.26	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $453.97 / $734.25 / $2,677.30	Professional		$453.97	$734.25	$2,677.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $696.25 / $1,151.96 / $1,556.69	Professional		$696.25	$1,151.96	$1,556.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $837.03 / $1,209.60 / $1,361.90	Professional		$837.03	$1,209.60	$1,361.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $692.76 / $1,014.67 / $1,578.64	Facility		$692.76	$1,014.67	$1,578.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $775.20 / $903.44 / $1,693.30	Professional		$775.20	$903.44	$1,693.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $699.50 / $960.86 / $1,060.60	Facility		$699.50	$960.86	$1,060.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $734.25 / $1,223.63 / $5,626.00	Facility		$734.25	$1,223.63	$5,626.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $887.25 / $1,220.70 / $1,559.69	Professional		$887.25	$1,220.70	$1,559.69
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 Professional Modifier Low / Median / High Price $964.36 / $1,298.84 / $1,660.57	Professional		$964.36	$1,298.84	$1,660.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,113.00	Facility		$1,981.00	$9,074.00	$12,113.00
United Facility/Professional Professional Modifier Low / Median / High Price $790.24 / $1,216.67 / $1,668.19	Professional		$790.24	$1,216.67	$1,668.19