Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,230.27 / $3,630.78	Facility		$1,000.00	$1,230.27	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $602.56 / $1,230.27	Professional		$295.12	$602.56	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $2,344.23	Facility		$1,288.25	$1,288.25	$2,344.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $794.33 / $1,445.44	Professional		$162.18	$794.33	$1,445.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,737.80 / $2,041.74	Professional		$794.33	$1,737.80	$2,041.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $794.33 / $1,071.52	Professional		$446.68	$794.33	$1,071.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $1,513.56	Facility		$794.33	$794.33	$1,513.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,122.02 / $2,344.23	Facility		$416.87	$1,122.02	$2,344.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $794.33 / $1,122.02	Professional		$79.43	$794.33	$1,122.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,344.23 / $3,162.28	Facility		$1,202.26	$2,344.23	$3,162.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $676.08 / $954.99	Professional		$338.84	$676.08	$954.99
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $1,288.25	Facility		$954.99	$954.99	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $338.84 / $954.99	Professional		$190.55	$338.84	$954.99