Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $3,288.42 / $5,396.10	Facility		$2,698.05	$3,288.42	$5,396.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,778.99 / $3,705.23	Professional		$2,698.05	$2,778.99	$3,705.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,545.33 / $4,513.81 / $5,316.26	Facility		$2,545.33	$4,513.81	$5,316.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,054.40	Professional		$2,698.05	$2,698.05	$3,054.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,523.33 / $5,923.91 / $7,241.44	Professional		$4,523.33	$5,923.91	$7,241.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $2,832.95 / $5,800.81	Facility		$2,698.05	$2,832.95	$5,800.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,859.94 / $3,507.47	Professional		$2,698.05	$2,859.94	$3,507.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $3,372.56 / $8,094.15	Facility		$2,698.05	$3,372.56	$8,094.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $3,161.94 / $5,644.00	Facility		$2,698.05	$3,161.94	$5,644.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $3,161.94 / $3,436.20	Professional		$2,698.05	$3,161.94	$3,436.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,443.30 / $3,664.95 / $9,238.68	Facility		$2,443.30	$3,664.95	$9,238.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,237.66	Professional		$2,698.05	$2,698.05	$3,237.66
United Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,102.76	Professional		$2,698.05	$2,698.05	$3,102.76