Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,275.00 / $4,275.00 / $9,000.00	Facility		$4,275.00	$4,275.00	$9,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,735.00 / $3,735.00 / $4,275.00	Professional		$3,735.00	$3,735.00	$4,275.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,650.00 / $7,650.00 / $7,650.00	Facility		$7,650.00	$7,650.00	$7,650.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Professional		$3,825.00	$3,825.00	$3,825.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $808.33 / $932.35 / $1,005.98	Professional		$808.33	$932.35	$1,005.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $832.73 / $3,921.75 / $8,030.25	Facility		$832.73	$3,921.75	$8,030.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $830.07 / $5,390.24 / $10,365.85	Professional		$830.07	$5,390.24	$10,365.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,054.00 / $5,341.05 / $8,030.25	Facility		$1,054.00	$5,341.05	$8,030.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,156.71 / $5,130.00 / $5,343.75	Professional		$1,156.71	$5,130.00	$5,343.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,608.88 / $6,219.51 / $13,458.97	Facility		$2,608.88	$6,219.51	$13,458.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,275.00 / $4,275.00 / $4,275.00	Professional		$4,275.00	$4,275.00	$4,275.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $3,750.00 / $4,312.50	Professional		$3,750.00	$3,750.00	$4,312.50