Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $352.43 / $4,684.68 / $8,728.00	Facility		$352.43	$4,684.68	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.82 / $851.63 / $1,688.19	Professional		$192.82	$851.63	$1,688.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.79 / $756.14 / $2,068.48	Professional		$279.79	$756.14	$2,068.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $304.50 / $688.62 / $1,811.77	Professional		$304.50	$688.62	$1,811.77
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $208.59 / $759.52 / $1,888.92	Facility		$208.59	$759.52	$1,888.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $260.10 / $1,051.91 / $1,984.59	Professional		$260.10	$1,051.91	$1,984.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $344.38 / $1,343.65 / $1,552.39	Facility		$344.38	$1,343.65	$1,552.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $208.59 / $1,086.44 / $1,937.59	Facility		$208.59	$1,086.44	$1,937.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $308.20 / $964.73 / $2,055.48	Professional		$308.20	$964.73	$2,055.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,993.29 / $6,338.31 / $7,624.85	Facility		$4,993.29	$6,338.31	$7,624.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $306.87 / $546.14 / $2,139.46	Professional		$306.87	$546.14	$2,139.46
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 $1,118.83 / $1,760.57 / $2,402.27	Professional		$1,118.83	$1,760.57	$2,402.27