Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $602.56 / $954.99	Professional		$489.78	$602.56	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
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 $891.25 / $2,137.96 / $2,691.53	Professional		$891.25	$2,137.96	$2,691.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $870.96 / $1,174.90	Facility		$691.83	$870.96	$1,174.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $933.25 / $1,258.93	Professional		$870.96	$933.25	$1,258.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,000.00 / $1,148.15	Facility		$912.01	$1,000.00	$1,148.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,148.15 / $1,148.15	Professional		$1,000.00	$1,148.15	$1,148.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $954.99 / $1,412.54	Facility		$562.34	$954.99	$1,412.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,023.29 / $1,202.26	Professional		$87.10	$1,023.29	$1,202.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,621.81 / $4,466.84	Facility		$954.99	$1,621.81	$4,466.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,288.25 / $1,288.25	Professional		$1,174.90	$1,288.25	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $660.69 / $2,137.96	Facility		$489.78	$660.69	$2,137.96
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $954.99	Professional		$446.68	$501.19	$954.99