Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $950.00 / $1,500.00 / $1,765.00	Professional		$950.00	$1,500.00	$1,765.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,130.52 / $4,130.52 / $4,130.52	Facility		$4,130.52	$4,130.52	$4,130.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $471.32 / $857.39 / $1,234.52	Professional		$471.32	$857.39	$1,234.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $885.82 / $1,034.89 / $1,102.42	Professional		$885.82	$1,034.89	$1,102.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $161.99 / $1,300.00 / $2,339.25	Facility		$161.99	$1,300.00	$2,339.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $935.73 / $935.73 / $1,507.83	Professional		$935.73	$935.73	$1,507.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $597.33 / $796.44 / $896.06	Facility		$597.33	$796.44	$896.06
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,062.89 / $1,062.89 / $1,062.89	Professional		$1,062.89	$1,062.89	$1,062.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $161.99 / $1,500.00 / $2,400,000.00	Facility		$161.99	$1,500.00	$2,400,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $700.96 / $1,565.78 / $2,475,000.00	Professional		$700.96	$1,565.78	$2,475,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,067.49 / $4,822.52 / $6,090.68	Facility		$4,067.49	$4,822.52	$6,090.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $819.00 / $1,082.24 / $2,021.54	Professional		$819.00	$1,082.24	$2,021.54
United Facility/Professional Professional Modifier Low / Median / High Price $1,156.07 / $1,290.55 / $4,897.13	Professional		$1,156.07	$1,290.55	$4,897.13