Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,202.26 / $3,548.13	Facility		$977.24	$1,202.26	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $1,412.54	Professional		$575.44	$758.58	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $2,290.87	Facility		$1,258.93	$1,258.93	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $851.14 / $1,412.54	Professional		$371.54	$851.14	$1,412.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,659.59 / $2,041.74	Professional		$776.25	$1,659.59	$2,041.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $891.25	Facility		$776.25	$776.25	$891.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $794.33 / $1,096.48	Professional		$776.25	$794.33	$1,096.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $1,479.11	Facility		$776.25	$776.25	$1,479.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,096.48 / $2,290.87	Facility		$707.95	$1,096.48	$2,290.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $851.14 / $1,122.02	Professional		$371.54	$851.14	$1,122.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,290.87 / $3,090.30	Facility		$1,174.90	$2,290.87	$3,090.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $660.69 / $933.25	Professional		$630.96	$660.69	$933.25
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $1,258.93	Facility		$933.25	$933.25	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $933.25	Professional		$331.13	$331.13	$933.25