Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $4,365.16	Facility		$831.76	$831.76	$4,365.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,630.78 / $4,365.16 / $4,466.84	Professional		$3,630.78	$4,365.16	$4,466.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,912.51 / $8,912.51 / $8,912.51	Facility		$8,912.51	$8,912.51	$8,912.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $4,466.84 / $4,466.84	Professional		$4,466.84	$4,466.84	$4,466.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $3,235.94 / $3,467.37	Professional		$2,818.38	$3,235.94	$3,467.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $6,309.57	Facility		$2,238.72	$4,365.16	$6,309.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,630.78 / $4,466.84	Professional		$2,238.72	$3,630.78	$4,466.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $2,344.23	Facility		$831.76	$831.76	$2,344.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $4,365.16 / $6,760.83	Facility		$1,659.59	$4,365.16	$6,760.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $3,467.37 / $4,466.84	Professional		$79.43	$3,467.37	$4,466.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Professional		$831.76	$831.76	$831.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $4,168.69	Facility		$1,737.80	$1,737.80	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $6,309.57	Professional		$5,248.07	$5,248.07	$6,309.57