Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $272.30 / $4,704.00 / $8,728.00	Facility		$272.30	$4,704.00	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.61 / $175.86 / $660.30	Professional		$138.61	$175.86	$660.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.56 / $278.93 / $366.80	Professional		$174.56	$278.93	$366.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.87 / $284.20 / $319.99	Professional		$199.87	$284.20	$319.99
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $175.86 / $273.27 / $378.10	Facility		$175.86	$273.27	$378.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $190.74 / $240.00 / $397.86	Professional		$190.74	$240.00	$397.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $186.53 / $243.48 / $263.16	Facility		$186.53	$243.48	$263.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $175.86 / $311.10 / $1,738.00	Facility		$175.86	$311.10	$1,738.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $221.76 / $290.47 / $365.02	Professional		$221.76	$290.47	$365.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,868.81 / $5,124.10 / $6,421.06	Facility		$3,868.81	$5,124.10	$6,421.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $225.10 / $306.05 / $390.08	Professional		$225.10	$306.05	$390.08
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $192.40 / $276.56 / $389.40	Professional		$192.40	$276.56	$389.40