Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,145.35 / $4,962.67 / $11,324.92	Facility		$1,145.35	$4,962.67	$11,324.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $505.13 / $817.02 / $2,797.00	Professional		$505.13	$817.02	$2,797.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.00 / $736.00 / $736.00	Facility		$736.00	$736.00	$736.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $687.40 / $1,157.81 / $1,753.19	Professional		$687.40	$1,157.81	$1,753.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.19 / $1,347.95 / $1,617.16	Professional		$1,148.19	$1,347.95	$1,617.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $704.38 / $1,074.24 / $1,444.15	Facility		$704.38	$1,074.24	$1,444.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $903.72 / $1,056.48 / $1,624.43	Professional		$903.72	$1,056.48	$1,624.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $769.27 / $1,132.57 / $1,233.47	Facility		$769.27	$1,132.57	$1,233.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $755.85 / $1,184.04 / $2,919.00	Facility		$755.85	$1,184.04	$2,919.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $195.05 / $195.05 / $195.05	Facility	AS	$195.05	$195.05	$195.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,017.96 / $1,221.23 / $1,681.68	Professional		$1,017.96	$1,221.23	$1,681.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,846.16 / $6,142.31 / $7,227.91	Facility		$4,846.16	$6,142.31	$7,227.91
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $7,269.24 / $9,213.46 / $10,841.87	Facility	50	$7,269.24	$9,213.46	$10,841.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,116.11 / $1,436.90 / $1,931.21	Professional		$1,116.11	$1,436.90	$1,931.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00
United Facility/Professional Professional Modifier Low / Median / High Price $822.72 / $1,180.90 / $1,848.39	Professional		$822.72	$1,180.90	$1,848.39