Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,123.20 / $1,357.20 / $2,620.80	Facility		$1,123.20	$1,357.20	$2,620.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $673.92 / $907.92 / $1,825.20	Professional		$673.92	$907.92	$1,825.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,521.00 / $1,521.00 / $2,719.55	Facility		$1,521.00	$1,521.00	$2,719.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $547.55 / $1,032.53 / $1,679.54	Professional		$547.55	$1,032.53	$1,679.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $936.00 / $2,282.78 / $2,463.02	Professional		$936.00	$2,282.78	$2,463.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $561.60 / $936.00 / $1,952.03	Facility		$561.60	$936.00	$1,952.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $936.00 / $936.00 / $1,263.59	Professional		$936.00	$936.00	$1,263.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $936.00 / $982.80 / $2,066.21	Facility		$936.00	$982.80	$2,066.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $561.60 / $1,150.00 / $1,974.96	Facility		$561.60	$1,150.00	$1,974.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $936.00 / $1,029.59 / $1,347.84	Professional		$936.00	$1,029.59	$1,347.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,825.20 / $2,848.25 / $3,674.64	Facility		$1,825.20	$2,848.25	$3,674.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $851.76 / $1,740.06 / $2,617.00	Professional		$851.76	$1,740.06	$2,617.00
United Facility/Professional Professional Modifier Low / Median / High Price $393.12 / $393.12 / $1,123.20	Professional		$393.12	$393.12	$1,123.20