Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $602.56 / $912.01	Professional		$446.68	$602.56	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $2,187.76 / $2,691.53	Professional		$870.96	$2,187.76	$2,691.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $851.14 / $1,202.26	Facility		$676.08	$851.14	$1,202.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $912.01 / $1,230.27	Professional		$831.76	$912.01	$1,230.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,096.48 / $1,174.90	Facility		$891.25	$1,096.48	$1,174.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,122.02 / $1,174.90	Professional		$1,023.29	$1,122.02	$1,174.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $933.25 / $1,380.38	Facility		$562.34	$933.25	$1,380.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,000.00 / $1,174.90	Professional		$87.10	$1,000.00	$1,174.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,584.89 / $4,365.16	Facility		$933.25	$1,584.89	$4,365.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,258.93 / $1,258.93	Professional		$1,148.15	$1,258.93	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $794.33 / $2,187.76	Facility		$501.19	$794.33	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $501.19 / $954.99	Professional		$457.09	$501.19	$954.99