Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $851.14 / $1,412.54	Professional		$676.08	$851.14	$1,412.54
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 $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $3,090.30 / $3,801.89	Professional		$1,174.90	$3,090.30	$3,801.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,174.90 / $1,584.89	Facility		$933.25	$1,174.90	$1,584.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,230.27 / $1,659.59	Professional		$1,148.15	$1,230.27	$1,659.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,513.56 / $1,621.81	Facility		$1,230.27	$1,513.56	$1,621.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,548.82 / $1,621.81	Professional		$1,380.38	$1,548.82	$1,621.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,288.25 / $1,995.26	Facility		$831.76	$1,288.25	$1,995.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,348.96 / $1,621.81	Professional		$87.10	$1,348.96	$1,621.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,187.76 / $5,888.44	Facility		$1,288.25	$2,187.76	$5,888.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,737.80 / $1,737.80	Professional		$1,584.89	$1,737.80	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,290.87 / $3,090.30	Facility		$707.95	$2,290.87	$3,090.30
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $707.95 / $1,348.96	Professional		$645.65	$707.95	$1,348.96