Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $13,803.84	Facility		$1,174.90	$1,659.59	$13,803.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,897.79 / $8,128.31 / $10,715.19	Facility	50	$4,897.79	$8,128.31	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $741.31 / $1,659.59	Professional		$524.81	$741.31	$1,659.59
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $794.33 / $831.76 / $2,238.72	Professional	50	$794.33	$831.76	$2,238.72
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 $707.95 / $1,071.52 / $1,862.09	Professional		$707.95	$1,071.52	$1,862.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,230.27 / $1,778.28	Professional		$794.33	$1,230.27	$1,778.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,047.13 / $1,778.28	Facility		$660.69	$1,047.13	$1,778.28
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $4,897.79 / $8,128.31 / $10,715.19	Facility	50	$4,897.79	$8,128.31	$10,715.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,174.90 / $1,698.24	Professional		$831.76	$1,174.90	$1,698.24
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $794.33 / $831.76 / $2,238.72	Professional	50	$794.33	$831.76	$2,238.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,380.38 / $1,479.11	Facility		$1,000.00	$1,380.38	$1,479.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,023.29 / $1,698.24	Facility		$616.60	$1,023.29	$1,698.24
Providence Facility/Professional Facility Modifier 22 Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility	22	$1,174.90	$1,174.90	$1,174.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $1,202.26 / $1,737.80	Professional		$79.43	$1,202.26	$1,737.80
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 $1,122.02 / $1,445.44 / $1,905.46	Professional		$1,122.02	$1,445.44	$1,905.46
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 $776.25 / $1,230.27 / $1,862.09	Professional		$776.25	$1,230.27	$1,862.09