Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,031.25 / $2,356.25 / $4,550.00	Facility		$2,031.25	$2,356.25	$4,550.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $975.00 / $1,527.50 / $3,168.75	Professional		$975.00	$1,527.50	$3,168.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,640.63 / $2,640.63 / $4,721.43	Facility		$2,640.63	$2,640.63	$4,721.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $950.62 / $1,792.47 / $2,915.55	Professional		$950.62	$1,792.47	$2,915.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,625.00 / $3,962.94 / $4,275.79	Professional		$1,625.00	$3,962.94	$4,275.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $975.00 / $1,625.00 / $3,388.94	Facility		$975.00	$1,625.00	$3,388.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,625.00 / $1,625.00 / $2,193.75	Professional		$1,625.00	$1,625.00	$2,193.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,625.00 / $1,706.25 / $3,587.19	Facility		$1,625.00	$1,706.25	$3,587.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $975.00 / $1,950.00 / $3,428.75	Facility		$975.00	$1,950.00	$3,428.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,625.00 / $1,787.50 / $2,340.00	Professional		$1,625.00	$1,787.50	$2,340.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,168.75 / $4,944.88 / $6,379.59	Facility		$3,168.75	$4,944.88	$6,379.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,478.75 / $3,020.85 / $4,543.26	Professional		$1,478.75	$3,020.85	$4,543.26
United Facility/Professional Professional Modifier Low / Median / High Price $682.50 / $682.50 / $1,950.00	Professional		$682.50	$682.50	$1,950.00