Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $1,479.11	Professional		$575.44	$758.58	$1,479.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Professional		$741.31	$741.31	$741.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $2,754.23 / $3,388.44	Professional		$1,000.00	$2,754.23	$3,388.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,000.00 / $1,348.96	Facility		$794.33	$1,000.00	$1,348.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,071.52 / $1,445.44	Professional		$977.24	$1,071.52	$1,445.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,258.93 / $1,318.26	Facility		$1,047.13	$1,258.93	$1,318.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,318.26 / $1,318.26	Professional		$1,202.26	$1,318.26	$1,318.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,122.02 / $1,778.28	Facility		$794.33	$1,122.02	$1,778.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,148.15 / $1,412.54	Professional		$87.10	$1,148.15	$1,412.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $5,011.87	Facility		$1,096.48	$1,862.09	$5,011.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,479.11 / $1,479.11	Professional		$1,348.96	$1,479.11	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $2,041.74 / $2,754.23	Facility		$630.96	$2,041.74	$2,754.23
United Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $630.96 / $1,202.26	Professional		$575.44	$630.96	$1,202.26