Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,352.88 / $2,352.88 / $2,352.88	Facility		$2,352.88	$2,352.88	$2,352.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,579.73 / $1,579.73 / $7,750.21	Professional		$1,579.73	$1,579.73	$7,750.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,786.79 / $1,786.79 / $1,786.79	Facility		$1,786.79	$1,786.79	$1,786.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,518.77 / $1,786.79 / $2,273.92	Professional		$1,518.77	$1,786.79	$2,273.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,212.13 / $2,844.17 / $7,543.40	Professional		$2,212.13	$2,844.17	$7,543.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,579.73 / $2,374.88 / $3,160.19	Facility		$1,579.73	$2,374.88	$3,160.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $252.89 / $2,384.96 / $3,086.12	Professional		$252.89	$2,384.96	$3,086.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,623.20 / $3,086.12 / $3,476.21	Facility		$2,623.20	$3,086.12	$3,476.21
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,686.16 / $3,160.19 / $3,160.19	Professional		$2,686.16	$3,160.19	$3,160.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $865.13 / $2,164.23 / $3,160.19	Facility		$865.13	$2,164.23	$3,160.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,786.79 / $2,767.17 / $3,086.12	Professional		$1,786.79	$2,767.17	$3,086.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,467.76 / $4,467.76 / $5,255.26	Facility		$4,467.76	$4,467.76	$5,255.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,007.91 / $3,007.91 / $3,007.91	Professional		$3,007.91	$3,007.91	$3,007.91
United Facility/Professional Professional Modifier Low / Median / High Price $1,261.42 / $1,340.09 / $2,623.20	Professional		$1,261.42	$1,340.09	$2,623.20