Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Facility		$870.96	$870.96	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $831.76 / $1,548.82	Professional		$676.08	$831.76	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $2,951.21 / $3,715.35	Professional		$1,122.02	$2,951.21	$3,715.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,096.48 / $1,621.81	Facility		$870.96	$1,096.48	$1,621.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,174.90 / $1,584.89	Professional		$1,096.48	$1,174.90	$1,584.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,412.54 / $1,548.82	Facility		$1,148.15	$1,412.54	$1,548.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,445.44 / $1,548.82	Professional		$1,318.26	$1,445.44	$1,548.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,230.27 / $1,862.09	Facility		$870.96	$1,230.27	$1,862.09
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 $1,479.11 / $1,621.81 / $1,621.81	Professional		$1,479.11	$1,621.81	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $870.96 / $3,019.95	Facility		$676.08	$870.96	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $691.83 / $1,318.26	Professional		$616.60	$691.83	$1,318.26