Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,254.65 / $7,920.26 / $20,400.00	Facility		$1,254.65	$7,920.26	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $510.73 / $778.97 / $1,922.39	Professional		$510.73	$778.97	$1,922.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,211.00 / $2,211.00 / $2,211.00	Facility		$2,211.00	$2,211.00	$2,211.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.19 / $1,114.45 / $1,701.75	Professional		$676.19	$1,114.45	$1,701.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,123.85 / $1,317.02 / $1,579.31	Professional		$1,123.85	$1,317.02	$1,579.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $786.81 / $1,046.88 / $1,396.55	Facility		$786.81	$1,046.88	$1,396.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $855.27 / $1,026.84 / $1,584.28	Professional		$855.27	$1,026.84	$1,584.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $792.33 / $1,105.50 / $1,212.03	Facility		$792.33	$1,105.50	$1,212.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $786.81 / $1,141.25 / $9,178.00	Facility		$786.81	$1,141.25	$9,178.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $989.40 / $1,162.77 / $1,611.20	Professional		$989.40	$1,162.77	$1,611.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,846.16 / $6,565.08 / $14,391.80	Facility		$4,846.16	$6,565.08	$14,391.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,032.63 / $1,358.48 / $1,789.48	Professional		$1,032.63	$1,358.48	$1,789.48
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 $823.67 / $1,181.58 / $1,769.68	Professional		$823.67	$1,181.58	$1,769.68