Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $991.96 / $5,649.00 / $15,341.00	Facility		$991.96	$5,649.00	$15,341.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.08 / $622.77 / $1,688.81	Professional		$412.08	$622.77	$1,688.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,664.70 / $1,664.70 / $2,735.22	Facility		$1,664.70	$1,664.70	$2,735.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $487.96 / $866.99 / $1,269.52	Professional		$487.96	$866.99	$1,269.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $720.98 / $946.71 / $1,160.48	Professional		$720.98	$946.71	$1,160.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $496.95 / $816.12 / $1,211.60	Facility		$496.95	$816.12	$1,211.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $696.00 / $806.40 / $1,350.69	Professional		$696.00	$806.40	$1,350.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $644.87 / $874.35 / $921.25	Facility		$644.87	$874.35	$921.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $536.19 / $927.33 / $1,211.60	Facility		$536.19	$927.33	$1,211.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $767.36 / $991.08 / $1,298.65	Professional		$767.36	$991.08	$1,298.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,811.13 / $10,664.71 / $11,932.41	Facility		$7,811.13	$10,664.71	$11,932.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $843.82 / $1,073.19 / $1,370.93	Professional		$843.82	$1,073.19	$1,370.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,895.00 / $11,770.00 / $26,404.00	Facility		$1,895.00	$11,770.00	$26,404.00
United Facility/Professional Professional Modifier Low / Median / High Price $668.00 / $935.21 / $1,440.75	Professional		$668.00	$935.21	$1,440.75