Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.43 / $615.55 / $991.10	Facility		$494.43	$615.55	$991.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $500.50 / $146,775.00	Professional		$495.55	$500.50	$146,775.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.50 / $685.47 / $968.80	Facility		$467.50	$685.47	$968.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $537.62	Professional		$495.55	$495.55	$537.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $487.65 / $1,085.91 / $1,274.91	Professional		$487.65	$1,085.91	$1,274.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $495.55 / $708.64 / $1,065.43	Facility		$495.55	$708.64	$1,065.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $525.28 / $644.22	Professional		$495.55	$525.28	$644.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $494.43 / $618.04 / $1,030.74	Facility		$494.43	$618.04	$1,030.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $491.38 / $525.53 / $947.02	Facility		$491.38	$525.53	$947.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $584.38 / $605.50	Professional		$495.55	$584.38	$605.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $462.87 / $569.88 / $1,394.18	Facility		$462.87	$569.88	$1,394.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $495.55	Professional		$495.55	$495.55	$495.55
United Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $495.55	Professional		$495.55	$495.55	$495.55