Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $745.72 / $745.72 / $745.72	Facility		$745.72	$745.72	$745.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $500.64 / $500.64 / $2,889.57	Professional		$500.64	$500.64	$2,889.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $615.17 / $615.17 / $615.17	Facility		$615.17	$615.17	$615.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $522.90 / $615.17 / $707.82	Professional		$522.90	$615.17	$707.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $701.04 / $901.34 / $2,390.80	Professional		$701.04	$901.34	$2,390.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $500.64 / $752.62 / $1,001.49	Facility		$500.64	$752.62	$1,001.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.13 / $752.62 / $1,001.49	Professional		$95.13	$752.62	$1,001.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $901.34 / $1,001.49 / $1,201.79	Facility		$901.34	$1,001.49	$1,201.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $978.02 / $1,001.49 / $1,101.64	Professional		$978.02	$1,001.49	$1,101.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $274.17 / $716.78 / $1,001.49	Facility		$274.17	$716.78	$1,001.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $615.17 / $876.95 / $978.02	Professional		$615.17	$876.95	$978.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,415.89 / $1,415.89 / $1,665.46	Facility		$1,415.89	$1,415.89	$1,665.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $953.24 / $953.24 / $953.24	Professional		$953.24	$953.24	$953.24
United Facility/Professional Professional Modifier Low / Median / High Price $399.76 / $424.69 / $831.32	Professional		$399.76	$424.69	$831.32