Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $562.34 / $933.25	Facility		$389.05	$562.34	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $398.11 / $512.86	Professional		$389.05	$398.11	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $537.03 / $758.58	Facility		$371.54	$537.03	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $426.58	Professional		$389.05	$389.05	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $851.14 / $1,000.00	Professional		$389.05	$851.14	$1,000.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $416.87 / $776.25	Facility		$389.05	$416.87	$776.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $416.87 / $512.86	Professional		$91.20	$416.87	$512.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $489.78 / $812.83	Facility		$389.05	$489.78	$812.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $537.03 / $1,122.02	Facility		$389.05	$537.03	$1,122.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $389.05 / $446.68	Professional		$79.43	$389.05	$446.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $616.60 / $1,202.26	Facility		$354.81	$616.60	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $933.25	Facility		$389.05	$389.05	$933.25
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05