Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,546.07 / $1,546.07 / $1,546.07	Facility		$1,546.07	$1,546.07	$1,546.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $863.49 / $863.49 / $4,969.49	Professional		$863.49	$863.49	$4,969.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,116.58 / $1,116.58 / $1,116.58	Facility		$1,116.58	$1,116.58	$1,116.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $949.10 / $1,116.58 / $1,338.37	Professional		$949.10	$1,116.58	$1,338.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,192.00 / $1,532.57 / $4,956.74	Professional		$1,192.00	$1,532.57	$4,956.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $906.66 / $1,415.34 / $1,702.86	Facility		$906.66	$1,415.34	$1,702.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $161.78 / $1,413.92 / $1,702.86	Professional		$161.78	$1,413.92	$1,702.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,613.77 / $1,746.21 / $1,972.39	Facility		$1,613.77	$1,746.21	$1,972.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,702.86 / $1,702.86 / $1,793.08	Professional		$1,702.86	$1,702.86	$1,793.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $863.49 / $1,415.34 / $1,882.21	Facility		$863.49	$1,415.34	$1,882.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,116.58 / $1,515.69 / $1,746.21	Professional		$1,116.58	$1,515.69	$1,746.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,435.05 / $2,435.05 / $2,864.26	Facility		$2,435.05	$2,435.05	$2,864.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,651.97 / $1,651.97 / $1,651.97	Professional		$1,651.97	$1,651.97	$1,651.97
United Facility/Professional Professional Modifier Low / Median / High Price $763.03 / $859.28 / $1,653.26	Professional		$763.03	$859.28	$1,653.26