Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $4,704.00 / $8,728.00	Facility		$163.19	$4,704.00	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $104.40 / $390.58	Professional		$76.45	$104.40	$390.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.22 / $165.00 / $218.31	Professional		$109.22	$165.00	$218.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.47 / $170.55 / $192.02	Professional		$119.47	$170.55	$192.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.40 / $150.36 / $224.46	Facility		$104.40	$150.36	$224.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $119.56 / $134.55 / $237.67	Professional		$119.56	$134.55	$237.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.65 / $142.79 / $150.28	Facility		$104.65	$142.79	$150.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.40 / $179.01 / $2,724.00	Facility		$104.40	$179.01	$2,724.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $132.15 / $170.93 / $218.31	Professional		$132.15	$170.93	$218.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,536.02 / $8,364.56 / $10,637.18	Facility		$6,536.02	$8,364.56	$10,637.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $135.31 / $182.15 / $232.88	Professional		$135.31	$182.15	$232.88
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 $113.42 / $158.57 / $231.87	Professional		$113.42	$158.57	$231.87