Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,583.50 / $7,920.26 / $20,400.00	Facility		$1,583.50	$7,920.26	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $714.33 / $833.45 / $3,725.29	Professional		$714.33	$833.45	$3,725.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $940.49 / $1,570.78 / $2,122.13	Professional		$940.49	$1,570.78	$2,122.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,138.77 / $1,629.91 / $1,835.12	Professional		$1,138.77	$1,629.91	$1,835.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $833.45 / $1,388.94 / $2,056.67	Facility		$833.45	$1,388.94	$2,056.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,137.30 / $1,228.20 / $2,283.21	Professional		$1,137.30	$1,228.20	$2,283.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $929.88 / $1,322.69 / $1,445.86	Facility		$929.88	$1,322.69	$1,445.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $833.45 / $1,547.15 / $1,844.06	Facility		$833.45	$1,547.15	$1,844.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,218.28 / $1,688.00 / $2,128.67	Professional		$1,218.28	$1,688.00	$2,128.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,802.84 / $3,802.84 / $3,802.84	Facility		$3,802.84	$3,802.84	$3,802.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,321.70 / $1,770.64 / $2,263.73	Professional		$1,321.70	$1,770.64	$2,263.73
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,049.57 / $1,440.59 / $2,265.06	Professional		$1,049.57	$1,440.59	$2,265.06