Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $595.34 / $835.76 / $5,286.41	Professional		$595.34	$835.76	$5,286.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,036.33 / $1,036.33 / $1,036.33	Facility		$1,036.33	$1,036.33	$1,036.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $756.53 / $756.53 / $1,036.33	Professional		$756.53	$756.53	$1,036.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $961.92 / $2,910.46 / $3,795.97	Professional		$961.92	$2,910.46	$3,795.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $835.76 / $1,171.35 / $1,410.75	Facility		$835.76	$1,171.35	$1,410.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,011.63 / $1,274.85 / $1,374.17	Professional		$1,011.63	$1,274.85	$1,374.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,236.75 / $1,347.14 / $1,517.42	Facility		$1,236.75	$1,347.14	$1,517.42
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,374.17 / $1,374.17 / $1,374.17	Professional		$1,374.17	$1,374.17	$1,374.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $835.76 / $1,203.27 / $1,442.88	Facility		$835.76	$1,203.27	$1,442.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $756.53 / $1,203.27 / $1,511.59	Professional		$756.53	$1,203.27	$1,511.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,144.88 / $2,285.19 / $4,821.02	Facility		$1,144.88	$2,285.19	$4,821.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,181.79 / $1,511.59 / $1,511.59	Professional		$1,181.79	$1,511.59	$1,511.59
United Facility/Professional Professional Modifier Low / Median / High Price $655.00 / $685.56 / $1,341.96	Professional		$655.00	$685.56	$1,341.96