Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,617.75 / $15,863.01 / $21,735.00	Facility		$2,617.75	$15,863.01	$21,735.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,302.75 / $1,653.20 / $3,757.54	Professional		$1,302.75	$1,653.20	$3,757.54
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 $1,262.61 / $2,014.72 / $3,136.50	Professional		$1,262.61	$2,014.72	$3,136.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,187.17 / $2,481.42 / $2,757.15	Professional		$1,187.17	$2,481.42	$2,757.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,279.23 / $2,136.78 / $3,824.27	Facility		$1,279.23	$2,136.78	$3,824.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,877.62 / $2,229.60 / $3,544.95	Professional		$1,877.62	$2,229.60	$3,544.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,650.21 / $2,300.78 / $3,041.13	Facility		$1,650.21	$2,300.78	$3,041.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,449.24 / $2,760.71 / $10,990.00	Facility		$1,449.24	$2,760.71	$10,990.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $441.71 / $441.71 / $441.71	Facility	80	$441.71	$441.71	$441.71
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $131.16 / $375.46 / $375.46	Facility	AS	$131.16	$375.46	$375.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,875.48 / $2,303.16 / $3,162.68	Professional		$1,875.48	$2,303.16	$3,162.68
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 $2,144.61 / $2,307.10 / $3,248.13	Professional		$2,144.61	$2,307.10	$3,248.13
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 $1,653.75 / $2,351.90 / $3,468.27	Professional		$1,653.75	$2,351.90	$3,468.27