Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,220.36 / $4,704.00 / $8,728.00	Facility		$1,220.36	$4,704.00	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $563.62 / $725.02 / $2,951.65	Professional		$563.62	$725.02	$2,951.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $780.01 / $1,201.27 / $1,628.48	Professional		$780.01	$1,201.27	$1,628.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $887.73 / $1,257.18 / $1,415.46	Professional		$887.73	$1,257.18	$1,415.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $725.02 / $1,138.25 / $1,558.79	Facility		$725.02	$1,138.25	$1,558.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $828.75 / $1,038.05 / $1,769.69	Professional		$828.75	$1,038.05	$1,769.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $790.70 / $1,074.68 / $1,109.76	Facility		$790.70	$1,074.68	$1,109.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $725.02 / $1,246.26 / $1,558.79	Facility		$725.02	$1,246.26	$1,558.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $985.40 / $1,296.83 / $1,628.48	Professional		$985.40	$1,296.83	$1,628.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,525.75 / $22,870.85 / $34,486.44	Facility		$11,525.75	$22,870.85	$34,486.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,009.88 / $1,358.75 / $1,737.14	Professional		$1,009.88	$1,358.75	$1,737.14
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $862.31 / $1,347.98 / $1,822.63	Professional		$862.31	$1,347.98	$1,822.63