Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $356.22 / $3,120.00 / $3,120.00	Facility		$356.22	$3,120.00	$3,120.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $356.22 / $1,263.59 / $1,326.00	Professional		$356.22	$1,263.59	$1,326.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $356.22 / $356.22 / $712.44	Facility		$356.22	$356.22	$712.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,326.00 / $1,326.00 / $1,326.00	Professional		$1,326.00	$1,326.00	$1,326.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $318.49 / $383.64 / $486.31	Professional		$318.49	$383.64	$486.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $144.10 / $460.99 / $1,851.56	Facility		$144.10	$460.99	$1,851.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $174.50 / $317.82 / $481.23	Professional		$174.50	$317.82	$481.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $453.35 / $79,999.20 / $79,999.20	Facility		$453.35	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $167.63 / $436.54 / $1,716.00	Facility		$167.63	$436.54	$1,716.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $384.15 / $436.54 / $1,326.00	Professional		$384.15	$436.54	$1,326.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $349.38 / $592.29 / $1,352.01	Facility		$349.38	$592.29	$1,352.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $356.22 / $356.22 / $356.22	Professional		$356.22	$356.22	$356.22
United Facility/Professional Professional Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $1,508.00	Professional		$1,300.00	$1,300.00	$1,508.00