Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.38 / $4,704.00 / $8,728.00	Facility		$170.38	$4,704.00	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.77 / $101.08 / $414.44	Professional		$76.77	$101.08	$414.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.78 / $176.72 / $260.06	Professional		$115.78	$176.72	$260.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.91 / $180.45 / $204.09	Professional		$125.91	$180.45	$204.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $101.08 / $164.34 / $217.32	Facility		$101.08	$164.34	$217.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $125.42 / $147.19 / $249.31	Professional		$125.42	$147.19	$249.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $110.95 / $150.08 / $154.77	Facility		$110.95	$150.08	$154.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $101.08 / $192.56 / $2,724.00	Facility		$101.08	$192.56	$2,724.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.16 / $178.75 / $226.79	Professional		$137.16	$178.75	$226.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,993.29 / $6,006.10 / $7,624.85	Facility		$4,993.29	$6,006.10	$7,624.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $140.22 / $189.54 / $242.32	Professional		$140.22	$189.54	$242.32
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 $118.72 / $185.58 / $253.07	Professional		$118.72	$185.58	$253.07