Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $708.10 / $786.42 / $1,261.24	Professional		$708.10	$786.42	$1,261.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $840.60 / $840.60 / $840.60	Facility		$840.60	$840.60	$840.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $613.64 / $613.64 / $840.60	Professional		$613.64	$613.64	$840.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,008.27 / $2,665.44 / $3,476.39	Professional		$1,008.27	$2,665.44	$3,476.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $864.03 / $1,183.72 / $1,440.38	Facility		$864.03	$1,183.72	$1,440.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,070.97 / $1,353.96 / $1,512.40	Professional		$1,070.97	$1,353.96	$1,512.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,143.33 / $1,296.33 / $1,440.38	Facility		$1,143.33	$1,296.33	$1,440.38
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,264.46 / $1,440.38 / $1,440.38	Professional		$1,264.46	$1,440.38	$1,440.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $840.60 / $1,235.56 / $1,512.40	Facility		$840.60	$1,235.56	$1,512.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $613.64 / $1,261.24 / $1,584.42	Professional		$613.64	$1,261.24	$1,584.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,200.04 / $2,395.28 / $5,053.28	Facility		$1,200.04	$2,395.28	$5,053.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,238.73 / $1,584.42 / $1,584.42	Professional		$1,238.73	$1,584.42	$1,584.42
United Facility/Professional Professional Modifier Low / Median / High Price $597.48 / $627.88 / $1,197.90	Professional		$597.48	$627.88	$1,197.90