Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $891.25 / $1,380.38	Professional		$645.65	$891.25	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Professional		$660.69	$660.69	$660.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $3,162.28 / $3,890.45	Professional		$1,122.02	$3,162.28	$3,890.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,096.48 / $1,621.81	Facility		$891.25	$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 / $1,584.89	Facility		$1,148.15	$1,412.54	$1,584.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,445.44 / $1,584.89	Professional		$1,318.26	$1,445.44	$1,584.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,258.93 / $2,041.74	Facility		$794.33	$1,258.93	$2,041.74
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 $630.96 / $977.24 / $3,162.28	Facility		$630.96	$977.24	$3,162.28
United Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $724.44 / $1,380.38	Professional		$660.69	$724.44	$1,380.38