Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $790.04 / $1,128.71 / $4,976.75	Facility		$790.04	$1,128.71	$4,976.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $771.56 / $1,805.99 / $3,640.00	Professional		$771.56	$1,805.99	$3,640.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $727.88 / $1,133.58 / $1,591.72	Facility		$727.88	$1,133.58	$1,591.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $771.56 / $771.56 / $837.07	Professional		$771.56	$771.56	$837.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $771.56 / $1,734.34 / $2,108.11	Professional		$771.56	$1,734.34	$2,108.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $771.56 / $1,103.33 / $1,658.85	Facility		$771.56	$1,103.33	$1,658.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $771.56 / $817.85 / $1,003.03	Professional		$771.56	$817.85	$1,003.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $771.55 / $964.45 / $1,639.70	Facility		$771.55	$964.45	$1,639.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $771.56 / $1,133.58 / $1,736.48	Facility		$771.56	$1,133.58	$1,736.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $837.06 / $1,001.34 / $1,110.00	Professional		$837.06	$1,001.34	$1,110.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $963.24 / $1,397.66 / $3,167.75	Facility		$963.24	$1,397.66	$3,167.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $771.56 / $771.56 / $771.56	Professional		$771.56	$771.56	$771.56
United Facility/Professional Professional Modifier Low / Median / High Price $771.56 / $771.56 / $771.56	Professional		$771.56	$771.56	$771.56