Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.50 / $536.57 / $1,110.00	Professional		$428.50	$536.57	$1,110.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $486.48 / $864.31 / $1,298.19	Professional		$486.48	$864.31	$1,298.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $802.07 / $1,037.56 / $1,252.54	Professional		$802.07	$1,037.56	$1,252.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $493.55 / $766.13 / $1,174.73	Facility		$493.55	$766.13	$1,174.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $680.88 / $817.68 / $1,226.85	Professional		$680.88	$817.68	$1,226.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $624.67 / $859.61 / $992.27	Facility		$624.67	$859.61	$992.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $490.04 / $786.18 / $1,262.27	Facility		$490.04	$786.18	$1,262.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $734.99 / $1,007.05 / $1,303.95	Professional		$734.99	$1,007.05	$1,303.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $805.04 / $1,051.77 / $1,347.17	Professional		$805.04	$1,051.77	$1,347.17
United Facility/Professional Professional Modifier Low / Median / High Price $616.80 / $870.04 / $1,335.42	Professional		$616.80	$870.04	$1,335.42