Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.00 / $336.00 / $336.00	Facility		$336.00	$336.00	$336.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.67 / $202.67 / $1,166.60	Professional		$202.67	$202.67	$1,166.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.97 / $265.97 / $265.97	Facility		$265.97	$265.97	$265.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $226.07 / $265.97 / $315.91	Professional		$226.07	$265.97	$315.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $264.68 / $340.31 / $1,077.21	Professional		$264.68	$340.31	$1,077.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $202.67 / $440.93 / $505.69	Facility		$202.67	$440.93	$505.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $360.27 / $480.41	Professional		$41.16	$360.27	$480.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $378.12 / $440.93 / $495.85	Facility		$378.12	$440.93	$495.85
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $378.12 / $411.19 / $472.37	Professional		$378.12	$411.19	$472.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $202.67 / $355.72 / $586.38	Facility		$202.67	$355.72	$586.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $265.97 / $355.72 / $447.58	Professional		$265.97	$355.72	$447.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $571.64 / $571.64 / $672.40	Facility		$571.64	$571.64	$672.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $387.65 / $387.65 / $387.65	Professional		$387.65	$387.65	$387.65
United Facility/Professional Professional Modifier Low / Median / High Price $201.72 / $230.04 / $387.65	Professional		$201.72	$230.04	$387.65