Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,000.00 / $1,659.59	Facility		$691.83	$1,000.00	$1,659.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $891.25	Professional		$691.83	$691.83	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,096.48 / $1,288.25	Facility		$645.65	$1,096.48	$1,288.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $776.25	Professional		$691.83	$691.83	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,445.44 / $1,737.80	Professional		$691.83	$1,445.44	$1,737.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $724.44 / $1,380.38	Facility		$691.83	$724.44	$1,380.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $724.44 / $1,071.52	Professional		$691.83	$724.44	$1,071.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $691.83 / $1,096.48	Facility		$602.56	$691.83	$1,096.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $707.95 / $1,258.93	Facility		$691.83	$707.95	$1,258.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $691.83 / $870.96	Professional		$79.43	$691.83	$870.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $977.24 / $1,862.09	Facility		$562.34	$977.24	$1,862.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $758.58	Professional		$691.83	$691.83	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $1,659.59	Facility		$691.83	$691.83	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $776.25	Professional		$691.83	$691.83	$776.25