Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $812.83 / $1,380.38	Professional		$630.96	$812.83	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $2,884.03 / $3,630.78	Professional		$1,023.29	$2,884.03	$3,630.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,023.29 / $1,548.82	Facility		$831.76	$1,023.29	$1,548.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,096.48 / $1,479.11	Professional		$1,000.00	$1,096.48	$1,479.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,318.26 / $1,513.56	Facility		$1,071.52	$1,318.26	$1,513.56
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,348.96 / $1,513.56	Professional		$1,202.26	$1,348.96	$1,513.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,148.15 / $1,737.80	Facility		$794.33	$1,148.15	$1,737.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,174.90 / $1,412.54	Professional		$87.10	$1,174.90	$1,412.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,905.46 / $5,128.61	Facility		$1,122.02	$1,905.46	$5,128.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,513.56 / $1,513.56	Professional		$1,380.38	$1,513.56	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $776.25 / $2,951.21	Facility		$630.96	$776.25	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $676.08 / $1,288.25	Professional		$602.56	$676.08	$1,288.25