Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,006.14 / $7,920.26 / $20,400.00	Facility		$1,006.14	$7,920.26	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.93 / $686.22 / $1,400.76	Professional		$416.93	$686.22	$1,400.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $210.69 / $210.69 / $707.45	Professional	50	$210.69	$210.69	$707.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $853.00 / $853.00 / $853.00	Facility		$853.00	$853.00	$853.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $544.30 / $885.17 / $1,561.61	Professional		$544.30	$885.17	$1,561.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $633.22 / $1,062.79 / $1,445.89	Professional		$633.22	$1,062.79	$1,445.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $559.74 / $947.25 / $1,453.33	Facility		$559.74	$947.25	$1,453.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $747.30 / $983.10 / $1,441.86	Professional		$747.30	$983.10	$1,441.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $715.26 / $1,113.74 / $1,248.88	Facility		$715.26	$1,113.74	$1,248.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $596.03 / $1,066.60 / $6,123.60	Facility		$596.03	$1,066.60	$6,123.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $802.56 / $1,094.86 / $1,487.88	Professional		$802.56	$1,094.86	$1,487.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,454.55 / $6,944.43 / $8,747.84	Facility		$5,454.55	$6,944.43	$8,747.84
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,181.83 / $10,416.65 / $13,121.76	Facility	50	$8,181.83	$10,416.65	$13,121.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $825.37 / $1,174.25 / $1,627.50	Professional		$825.37	$1,174.25	$1,627.50
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 $765.45 / $1,120.00 / $1,647.63	Professional		$765.45	$1,120.00	$1,647.63