Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $993.75 / $1,152.75 / $2,226.00	Facility		$993.75	$1,152.75	$2,226.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.29 / $771.15 / $1,152.75	Professional		$588.29	$771.15	$1,152.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,291.88 / $1,989.49 / $2,309.87	Facility		$1,291.88	$1,989.49	$2,309.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $698.00 / $876.97 / $1,426.35	Professional		$698.00	$876.97	$1,426.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $1,938.88 / $2,091.94	Professional		$795.00	$1,938.88	$2,091.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $397.50 / $795.00 / $1,657.97	Facility		$397.50	$795.00	$1,657.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $795.00 / $1,073.25	Professional		$795.00	$795.00	$1,073.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $795.00 / $834.75 / $1,754.96	Facility		$795.00	$834.75	$1,754.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $397.50 / $954.00 / $1,733.10	Facility		$397.50	$954.00	$1,733.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $874.50 / $1,144.80	Professional		$795.00	$874.50	$1,144.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,550.25 / $2,419.19 / $3,121.09	Facility		$1,550.25	$2,419.19	$3,121.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $723.45 / $1,477.98 / $2,222.84	Professional		$723.45	$1,477.98	$2,222.84
United Facility/Professional Professional Modifier Low / Median / High Price $333.90 / $333.90 / $954.00	Professional		$333.90	$333.90	$954.00