Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,479.11 / $13,803.84	Facility		$1,000.00	$1,479.11	$13,803.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,309.57 / $10,471.29 / $15,488.17	Facility	50	$6,309.57	$10,471.29	$15,488.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $707.95 / $1,621.81	Professional		$478.63	$707.95	$1,621.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $407.38 / $1,000.00 / $2,951.21	Professional	50	$407.38	$1,000.00	$2,951.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $933.25 / $1,621.81	Professional		$602.56	$933.25	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,047.13 / $1,584.89	Professional		$707.95	$1,047.13	$1,584.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $891.25 / $1,548.82	Facility		$562.34	$891.25	$1,548.82
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $6,309.57 / $10,471.29 / $15,488.17	Facility	50	$6,309.57	$10,471.29	$15,488.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,047.13 / $1,584.89	Professional		$741.31	$1,047.13	$1,584.89
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $416.87 / $630.96 / $2,691.53	Professional	50	$416.87	$630.96	$2,691.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,202.26 / $1,318.26	Facility		$870.96	$1,202.26	$1,318.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $870.96 / $1,412.54	Facility		$524.81	$870.96	$1,412.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $1,023.29 / $1,513.56	Professional		$79.43	$1,023.29	$1,513.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $7,413.10 / $8,709.64	Facility		$5,495.41	$7,413.10	$8,709.64
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,128.31 / $10,964.78 / $13,182.57	Facility	50	$8,128.31	$10,964.78	$13,182.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,258.93 / $1,659.59	Professional		$954.99	$1,258.93	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $9,549.93 / $12,882.50	Facility		$1,995.26	$9,549.93	$12,882.50
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,047.13 / $1,659.59	Professional		$691.83	$1,047.13	$1,659.59