Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $645.65 / $1,148.15	Professional		$478.63	$645.65	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Facility		$707.95	$707.95	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Professional		$524.81	$524.81	$524.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $2,344.23 / $2,884.03	Professional		$954.99	$2,344.23	$2,884.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $933.25 / $1,258.93	Facility		$741.31	$933.25	$1,258.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,000.00 / $1,348.96	Professional		$933.25	$1,000.00	$1,348.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,071.52 / $1,230.27	Facility		$977.24	$1,071.52	$1,230.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,230.27 / $1,230.27	Professional		$1,071.52	$1,230.27	$1,230.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,023.29 / $1,513.56	Facility		$630.96	$1,023.29	$1,513.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,096.48 / $1,318.26	Professional		$87.10	$1,096.48	$1,318.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,737.80 / $4,786.30	Facility		$1,047.13	$1,737.80	$4,786.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,380.38 / $1,380.38	Professional		$1,258.93	$1,380.38	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,778.28 / $2,344.23	Facility		$537.03	$1,778.28	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $537.03 / $1,023.29	Professional		$489.78	$537.03	$1,023.29