Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $794.33 / $1,584.89	Professional		$407.38	$794.33	$1,584.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Professional		$588.84	$588.84	$588.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $851.14 / $1,047.13	Professional		$302.00	$851.14	$1,047.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $1,000.00 / $1,000.00	Facility		$407.38	$1,000.00	$1,000.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $602.56 / $1,047.13	Professional		$380.19	$602.56	$1,047.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $588.84 / $1,122.02	Facility		$398.11	$588.84	$1,122.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Professional		$1,122.02	$1,122.02	$1,122.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $537.03 / $1,479.11	Facility		$407.38	$537.03	$1,479.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $588.84 / $1,071.52	Professional		$87.10	$588.84	$1,071.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $1,148.15 / $2,187.76	Facility		$562.34	$1,148.15	$2,187.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $446.68 / $1,174.90	Professional		$426.58	$446.68	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,737.80 / $2,290.87	Facility		$630.96	$1,737.80	$2,290.87
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $630.96 / $1,000.00	Professional		$416.87	$630.96	$1,000.00