Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,093.49 / $7,920.26 / $20,400.00	Facility		$1,093.49	$7,920.26	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $477.16 / $575.17 / $2,543.63	Professional		$477.16	$575.17	$2,543.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $640.26 / $1,073.93 / $1,463.27	Professional		$640.26	$1,073.93	$1,463.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $796.74 / $1,142.42 / $1,290.65	Professional		$796.74	$1,142.42	$1,290.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $575.17 / $958.54 / $1,236.64	Facility		$575.17	$958.54	$1,236.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $712.96 / $843.43 / $1,580.83	Professional		$712.96	$843.43	$1,580.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $644.39 / $881.55 / $996.96	Facility		$644.39	$881.55	$996.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $575.17 / $1,057.78 / $1,260.55	Facility		$575.17	$1,057.78	$1,260.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $830.34 / $1,146.40 / $1,461.08	Professional		$830.34	$1,146.40	$1,461.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $18,892.24 / $23,665.33 / $28,288.01	Facility		$18,892.24	$23,665.33	$28,288.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $903.48 / $1,220.90 / $1,560.91	Professional		$903.48	$1,220.90	$1,560.91
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $17,192.00 / $27,773.36	Facility		$2,912.00	$17,192.00	$27,773.36
United Facility/Professional Professional Modifier Low / Median / High Price $734.05 / $1,147.47 / $1,562.86	Professional		$734.05	$1,147.47	$1,562.86