Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,412.54 / $5,011.87	Facility		$758.58	$1,412.54	$5,011.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,778.28 / $3,630.78	Professional		$758.58	$1,778.28	$3,630.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,122.02 / $1,584.89	Facility		$724.44	$1,122.02	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $831.76	Professional		$758.58	$758.58	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,659.59 / $1,995.26	Professional		$758.58	$1,659.59	$1,995.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $812.83 / $1,513.56	Facility		$758.58	$812.83	$1,513.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $891.25 / $2,238.72	Professional		$758.58	$891.25	$2,238.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $954.99 / $1,584.89	Facility		$776.25	$954.99	$1,584.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,122.02 / $2,344.23	Facility		$758.58	$1,122.02	$2,344.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $724.44 / $1,000.00	Professional		$79.43	$724.44	$1,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,621.81 / $2,951.21	Facility		$954.99	$1,621.81	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,819.70	Facility		$758.58	$758.58	$1,819.70
United Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $794.33	Professional		$758.58	$758.58	$794.33