Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $1,513.56	Professional		$630.96	$851.14	$1,513.56
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 $1,230.27 / $3,090.30 / $3,801.89	Professional		$1,230.27	$3,090.30	$3,801.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,202.26 / $1,737.80	Facility		$954.99	$1,202.26	$1,737.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,288.25 / $1,737.80	Professional		$1,174.90	$1,288.25	$1,737.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,412.54 / $1,621.81	Facility		$1,288.25	$1,412.54	$1,621.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,621.81 / $1,621.81	Professional		$1,412.54	$1,621.81	$1,621.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,318.26 / $2,041.74	Facility		$831.76	$1,318.26	$2,041.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,412.54 / $1,698.24	Professional		$87.10	$1,412.54	$1,698.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,290.87 / $6,165.95	Facility		$1,348.96	$2,290.87	$6,165.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,819.70 / $1,819.70	Professional		$1,621.81	$1,819.70	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $912.01 / $3,090.30	Facility		$707.95	$912.01	$3,090.30
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $707.95 / $1,348.96	Professional		$645.65	$707.95	$1,348.96