Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $4,283.46 / $8,728.00	Facility		$765.00	$4,283.46	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $880.00 / $1,811.20 / $4,568.00	Professional		$880.00	$1,811.20	$4,568.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,664.70 / $1,664.70 / $1,664.70	Facility		$1,664.70	$1,664.70	$1,664.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,639.26 / $1,639.26 / $1,639.26	Professional		$1,639.26	$1,639.26	$1,639.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $3,766.50 / $3,766.50 / $3,766.50	Facility		$3,766.50	$3,766.50	$3,766.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $243.52 / $243.52 / $243.52	Professional		$243.52	$243.52	$243.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,177.62 / $5,613.04 / $13,964.00	Facility		$4,177.62	$5,613.04	$13,964.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,664.70 / $1,664.70 / $1,647,300.28	Facility		$1,664.70	$1,664.70	$1,647,300.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,624.30 / $18,659.50 / $21,600.03	Facility		$13,624.30	$18,659.50	$21,600.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,851.10 / $6,572.57 / $7,106.61	Professional		$3,851.10	$6,572.57	$7,106.61
United Facility/Professional Facility Modifier Low / Median / High Price $2,151.00 / $15,055.00 / $24,231.00	Facility		$2,151.00	$15,055.00	$24,231.00