Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $660.69 / $1,000.00	Professional		$501.19	$660.69	$1,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $2,398.83 / $2,951.21	Professional		$912.01	$2,398.83	$2,951.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $891.25 / $1,288.25	Facility		$724.44	$891.25	$1,288.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $954.99 / $1,288.25	Professional		$870.96	$954.99	$1,288.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,174.90 / $1,202.26	Facility		$954.99	$1,174.90	$1,202.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Professional		$1,202.26	$1,202.26	$1,202.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,000.00 / $1,513.56	Facility		$588.84	$1,000.00	$1,513.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,047.13 / $1,258.93	Professional		$87.10	$1,047.13	$1,258.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,698.24 / $4,570.88	Facility		$1,000.00	$1,698.24	$4,570.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,348.96 / $1,348.96	Professional		$1,202.26	$1,348.96	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,778.28 / $2,398.83	Facility		$588.84	$1,778.28	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $549.54 / $1,047.13	Professional		$489.78	$549.54	$1,047.13