Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $496.51 / $620.64 / $993.48	Facility		$496.51	$620.64	$993.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $496.51 / $501.71 / $638.83	Professional		$496.51	$501.71	$638.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $468.62 / $700.43 / $993.36	Facility		$468.62	$700.43	$993.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $496.74 / $538.91	Professional		$496.74	$496.74	$538.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.57 / $1,090.19 / $1,302.15	Professional		$489.57	$1,090.19	$1,302.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $496.74 / $710.34 / $1,067.99	Facility		$496.74	$710.34	$1,067.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $526.54 / $645.76	Professional		$496.74	$526.54	$645.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $491.40 / $496.74 / $1,030.48	Facility		$491.40	$496.74	$1,030.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $509.95 / $536.99 / $982.80	Facility		$509.95	$536.99	$982.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $585.78 / $618.71	Professional		$496.74	$585.78	$618.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $481.77 / $571.25 / $1,450.56	Facility		$481.77	$571.25	$1,450.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $496.74 / $496.74	Professional		$496.74	$496.74	$496.74
United Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $496.74 / $496.74	Professional		$496.74	$496.74	$496.74