Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $691.83 / $1,148.15	Professional		$512.86	$691.83	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $2,511.89 / $3,090.30	Professional		$933.25	$2,511.89	$3,090.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $933.25 / $1,348.96	Facility		$741.31	$933.25	$1,348.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,000.00 / $1,348.96	Professional		$912.01	$1,000.00	$1,348.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,148.15 / $1,230.27	Facility		$977.24	$1,148.15	$1,230.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,230.27 / $1,230.27	Professional		$1,096.48	$1,230.27	$1,230.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,047.13 / $1,584.89	Facility		$602.56	$1,047.13	$1,584.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,071.52 / $1,288.25	Professional		$87.10	$1,071.52	$1,288.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,737.80 / $4,677.35	Facility		$1,023.29	$1,737.80	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,380.38 / $1,380.38	Professional		$1,258.93	$1,380.38	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $776.25 / $2,511.89	Facility		$478.63	$776.25	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $575.44 / $1,096.48	Professional		$524.81	$575.44	$1,096.48