Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $583.00 / $922.45 / $5,176.82	Professional		$583.00	$922.45	$5,176.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $870.50 / $870.50 / $870.50	Facility		$870.50	$870.50	$870.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $635.47 / $870.50	Professional		$635.47	$635.47	$870.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,061.69 / $2,850.09 / $3,717.25	Professional		$1,061.69	$2,850.09	$3,717.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $922.45 / $1,263.76 / $1,516.70	Facility		$922.45	$1,263.76	$1,516.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,127.73 / $1,425.70 / $1,592.54	Professional		$1,127.73	$1,425.70	$1,592.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,203.93 / $1,516.70 / $1,794.25	Facility		$1,203.93	$1,516.70	$1,794.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,365.03 / $1,516.70 / $1,794.25	Professional		$1,365.03	$1,516.70	$1,794.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $809.03 / $1,305.40 / $1,592.54	Facility		$809.03	$1,305.40	$1,592.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $1,328.08 / $1,668.37	Professional		$635.47	$1,328.08	$1,668.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,263.63 / $2,522.21 / $5,321.09	Facility		$1,263.63	$2,522.21	$5,321.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,304.35 / $1,668.37 / $1,668.37	Professional		$1,304.35	$1,668.37	$1,668.37
United Facility/Professional Professional Modifier Low / Median / High Price $641.41 / $671.35 / $1,314.14	Professional		$641.41	$671.35	$1,314.14