Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,040.08 / $1,040.08 / $2,447.28	Facility		$1,040.08	$1,040.08	$2,447.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,015.62 / $1,015.62 / $1,040.08	Professional		$1,015.62	$1,015.62	$1,040.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,080.17 / $2,080.17 / $2,080.17	Facility		$2,080.17	$2,080.17	$2,080.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,040.08 / $1,040.08 / $1,040.08	Professional		$1,040.08	$1,040.08	$1,040.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $308.95 / $370.22	Professional		$138.74	$308.95	$370.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $300.26 / $1,346.00 / $2,183.58	Facility		$300.26	$1,346.00	$2,183.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $198.75 / $210.90 / $2,161.76	Professional		$198.75	$210.90	$2,161.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $957.19 / $79,999.20 / $79,999.20	Facility		$957.19	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,015.62 / $1,452.34 / $2,820.85	Facility		$1,015.62	$1,452.34	$2,820.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $248.59 / $452.26 / $1,274.63	Professional		$248.59	$452.26	$1,274.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $790.78 / $1,265.25 / $2,560.55	Facility		$790.78	$1,265.25	$2,560.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,040.08 / $1,040.08 / $1,040.08	Professional		$1,040.08	$1,040.08	$1,040.08
United Facility/Professional Professional Modifier Low / Median / High Price $1,019.70 / $1,019.70 / $1,223.64	Professional		$1,019.70	$1,019.70	$1,223.64