Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility		$1,621.81	$1,621.81	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,047.13 / $1,905.46	Professional		$870.96	$1,047.13	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,122.02 / $1,348.96	Professional		$954.99	$1,122.02	$1,348.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,584.89 / $4,786.30	Professional		$1,230.27	$1,584.89	$4,786.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $933.25 / $1,548.82	Facility		$123.03	$933.25	$1,548.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,548.82 / $1,778.28	Professional		$1,380.38	$1,548.82	$1,778.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,862.09	Facility		$1,698.24	$1,698.24	$1,862.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,778.28	Professional		$1,698.24	$1,698.24	$1,778.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,174.90 / $1,949.84	Facility		$912.01	$1,174.90	$1,949.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $954.99 / $1,862.09	Professional		$87.10	$954.99	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,454.71 / $5,623.41	Facility		$1,659.59	$2,454.71	$5,623.41
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $977.24 / $1,288.25	Facility		$128.82	$977.24	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $851.14 / $1,659.59	Professional		$741.31	$851.14	$1,659.59