Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $794.33 / $1,318.26	Facility		$524.81	$794.33	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $549.54 / $776.25	Professional		$524.81	$549.54	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $489.78 / $1,047.13	Facility		$426.58	$489.78	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $575.44	Professional		$524.81	$524.81	$575.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $1,174.90 / $1,380.38	Professional		$524.81	$1,174.90	$1,380.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $575.44 / $1,047.13	Facility		$524.81	$575.44	$1,047.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $575.44 / $954.99	Professional		$524.81	$575.44	$954.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $676.08 / $1,122.02	Facility		$549.54	$676.08	$1,122.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $758.58 / $1,148.15	Facility		$426.58	$758.58	$1,148.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $562.34 / $660.69	Professional		$79.43	$562.34	$660.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $891.25 / $1,862.09	Facility		$549.54	$891.25	$1,862.09
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $1,258.93	Facility		$524.81	$524.81	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Professional		$524.81	$524.81	$524.81