Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,758.00 / $9,338.46 / $30,593.00	Facility		$1,758.00	$9,338.46	$30,593.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.89 / $658.43 / $889.22	Professional		$412.89	$658.43	$889.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,375.60 / $4,375.60 / $4,375.60	Facility		$4,375.60	$4,375.60	$4,375.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $628.65 / $1,391.42 / $1,919.56	Professional		$628.65	$1,391.42	$1,919.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $823.34 / $1,171.26 / $1,651.04	Professional		$823.34	$1,171.26	$1,651.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $705.54 / $889.22 / $1,911.82	Facility		$705.54	$889.22	$1,911.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $756.75 / $756.75 / $756.75	Professional		$756.75	$756.75	$756.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $685.78 / $1,002.97 / $1,307.83	Facility		$685.78	$1,002.97	$1,307.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $705.53 / $889.22 / $1,911.82	Facility		$705.53	$889.22	$1,911.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $796.10 / $1,453.49 / $2,040.01	Professional		$796.10	$1,453.49	$2,040.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $18,832.95 / $36,371.73 / $50,994.29	Facility		$18,832.95	$36,371.73	$50,994.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,131.66 / $1,424.41 / $1,743.40	Professional		$1,131.66	$1,424.41	$1,743.40
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $25,540.00 / $51,981.00	Facility		$3,340.00	$25,540.00	$51,981.00
United Facility/Professional Professional Modifier Low / Median / High Price $626.96 / $1,100.14 / $1,505.30	Professional		$626.96	$1,100.14	$1,505.30