Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $891.25 / $2,630.27	Facility		$724.44	$891.25	$2,630.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $489.78 / $891.25	Professional		$380.19	$489.78	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,445.44 / $1,698.24	Facility		$933.25	$1,445.44	$1,698.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $660.69 / $1,047.13	Professional		$263.03	$660.69	$1,047.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,258.93 / $1,479.11	Professional		$575.44	$1,258.93	$1,479.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $575.44 / $776.25	Professional		$549.54	$575.44	$776.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $1,096.48	Facility		$575.44	$575.44	$1,096.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $812.83 / $1,698.24	Facility		$562.34	$812.83	$1,698.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $630.96 / $891.25	Professional		$275.42	$630.96	$891.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,737.80 / $2,398.83	Facility		$870.96	$1,737.80	$2,398.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $524.81 / $691.83	Professional		$407.38	$524.81	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $933.25	Facility		$691.83	$691.83	$933.25
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $691.83	Professional		$245.47	$245.47	$691.83