Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,068.63 / $16,342.00 / $20,400.00	Facility		$2,068.63	$16,342.00	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,153.21 / $1,467.38 / $3,276.57	Professional		$1,153.21	$1,467.38	$3,276.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $1,348.00 / $1,348.00	Facility		$1,348.00	$1,348.00	$1,348.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,090.04 / $1,751.92 / $2,736.81	Professional		$1,090.04	$1,751.92	$2,736.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,035.89 / $2,162.13 / $2,402.36	Professional		$1,035.89	$2,162.13	$2,402.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,114.61 / $1,838.39 / $3,344.49	Facility		$1,114.61	$1,838.39	$3,344.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,635.84 / $1,960.20 / $3,089.49	Professional		$1,635.84	$1,960.20	$3,089.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,433.64 / $1,982.53 / $2,689.70	Facility		$1,433.64	$1,982.53	$2,689.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,311.32 / $2,403.38 / $10,990.00	Facility		$1,311.32	$2,403.38	$10,990.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $384.54 / $384.54 / $384.54	Facility	80	$384.54	$384.54	$384.54
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $114.38 / $326.86 / $326.86	Facility	AS	$114.38	$326.86	$326.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,629.28 / $1,990.35 / $2,736.81	Professional		$1,629.28	$1,990.35	$2,736.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,762.34 / $13,653.30 / $16,115.95	Facility		$10,762.34	$13,653.30	$16,115.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,869.08 / $2,011.99 / $2,823.30	Professional		$1,869.08	$2,011.99	$2,823.30
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,413.12 / $2,001.92 / $2,896.76	Professional		$1,413.12	$2,001.92	$2,896.76