Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $933.25 / $933.25	Facility		$794.33	$933.25	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $831.76 / $1,318.26	Facility		$794.33	$831.76	$1,318.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,949.84 / $1,949.84	Facility		$416.87	$1,949.84	$1,949.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $870.96 / $1,412.54	Facility		$794.33	$870.96	$1,412.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $162.18 / $162.18	Professional		$79.43	$162.18	$162.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,511.89 / $3,090.30	Facility		$1,905.46	$2,511.89	$3,090.30
United Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,951.21 / $3,890.45	Facility		$2,398.83	$2,951.21	$3,890.45