Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.15 / $967.40 / $967.40	Facility		$411.15	$967.40	$967.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $386.96 / $401.47 / $689.73	Professional		$386.96	$401.47	$689.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $411.15 / $411.15 / $822.30	Facility		$411.15	$411.15	$822.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.15 / $411.15 / $411.15	Professional		$411.15	$411.15	$411.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $401.47 / $427.27 / $863.16	Facility		$401.47	$427.27	$863.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $427.27 / $427.27 / $427.27	Professional		$427.27	$427.27	$427.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $417.94 / $79,999.20 / $79,999.20	Facility		$417.94	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $401.47 / $427.27 / $863.16	Facility		$401.47	$427.27	$863.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $411.15 / $503.85 / $534.09	Professional		$411.15	$503.85	$534.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $427.27 / $640.91 / $1,383.50	Facility		$427.27	$640.91	$1,383.50
United Facility/Professional Professional Modifier Low / Median / High Price $403.08 / $403.08 / $463.54	Professional		$403.08	$403.08	$463.54