Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $549.54 / $812.83	Professional		$416.87	$549.54	$812.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Facility		$562.34	$562.34	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,949.84 / $2,454.71	Professional		$691.83	$1,949.84	$2,454.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $691.83 / $831.76	Facility		$645.65	$691.83	$831.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $724.44 / $1,000.00	Professional		$676.08	$724.44	$1,000.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $891.25 / $1,174.90	Facility		$724.44	$891.25	$1,174.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $912.01 / $1,174.90	Professional		$812.83	$912.01	$1,174.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $776.25 / $1,258.93	Facility		$478.63	$776.25	$1,258.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $794.33 / $954.99	Professional		$87.10	$794.33	$954.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,288.25 / $3,467.37	Facility		$758.58	$1,288.25	$3,467.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,023.29 / $1,023.29	Professional		$933.25	$1,023.29	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $467.74 / $1,995.26	Facility		$218.78	$467.74	$1,995.26
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $457.09 / $870.96	Professional		$407.38	$457.09	$870.96