Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Facility		$2,570.40	$2,570.40	$2,570.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,454.71 / $3,715.35	Professional		$1,862.09	$2,454.71	$3,715.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Facility		$3,162.28	$3,162.28	$3,162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Professional		$2,290.87	$2,290.87	$2,290.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $8,912.51 / $10,964.78	Professional		$3,235.94	$8,912.51	$10,964.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,162.28 / $4,265.80	Facility		$2,570.40	$3,162.28	$4,265.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,388.44 / $4,570.88	Professional		$3,090.30	$3,388.44	$4,570.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,168.69	Facility		$4,073.80	$4,073.80	$4,168.69
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Professional		$4,168.69	$4,168.69	$4,168.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $3,630.78 / $5,128.61	Facility		$2,089.30	$3,630.78	$5,128.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $3,630.78 / $4,365.16	Professional		$87.10	$3,630.78	$4,365.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $5,888.44 / $16,218.10	Facility		$3,467.37	$5,888.44	$16,218.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,677.35 / $4,677.35	Professional		$4,265.80	$4,677.35	$4,677.35
United Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $6,760.83 / $8,912.51	Facility		$2,754.23	$6,760.83	$8,912.51
United Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,041.74 / $3,890.45	Professional		$1,862.09	$2,041.74	$3,890.45