Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $724.44 / $1,122.02	Professional		$562.34	$724.44	$1,122.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $2,630.27 / $3,235.94	Professional		$1,122.02	$2,630.27	$3,235.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,122.02 / $1,513.56	Facility		$891.25	$1,122.02	$1,513.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,202.26 / $1,621.81	Professional		$1,096.48	$1,202.26	$1,621.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,202.26 / $1,479.11	Facility		$1,174.90	$1,202.26	$1,479.11
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,479.11 / $1,479.11	Professional		$1,202.26	$1,479.11	$1,479.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,174.90 / $1,778.28	Facility		$676.08	$1,174.90	$1,778.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,288.25 / $1,548.82	Professional		$87.10	$1,288.25	$1,548.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,089.30 / $5,623.41	Facility		$1,230.27	$2,089.30	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,659.59 / $1,659.59	Professional		$1,513.56	$1,659.59	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $870.96 / $2,630.27	Facility		$602.56	$870.96	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $602.56 / $1,148.15	Professional		$549.54	$602.56	$1,148.15