Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $446.68 / $524.81	Facility		$302.00	$446.68	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $489.78	Professional		$162.18	$218.78	$489.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $501.19 / $616.60	Professional		$338.84	$501.19	$616.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $416.87 / $489.78	Professional		$208.93	$416.87	$489.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $416.87 / $645.65	Facility		$208.93	$416.87	$645.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $398.11 / $616.60	Professional		$316.23	$398.11	$616.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $389.05 / $416.87	Facility		$302.00	$389.05	$416.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $426.58 / $1,000.00	Facility		$302.00	$426.58	$1,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $575.44	Professional		$295.12	$426.58	$575.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,258.93 / $1,621.81	Facility		$1,047.13	$1,258.93	$1,621.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $426.58 / $512.86	Professional		$380.19	$426.58	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,513.56 / $1,949.84	Facility		$1,202.26	$1,513.56	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $190.55 / $616.60	Professional		$186.21	$190.55	$616.60