Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,137.96	Facility		$2,137.96	$2,137.96	$2,137.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,949.84 / $3,019.95	Professional		$1,584.89	$1,949.84	$3,019.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Facility		$2,884.03	$2,884.03	$2,884.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Professional		$2,454.71	$2,454.71	$2,454.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $6,918.31 / $8,709.64	Professional		$2,691.53	$6,918.31	$8,709.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $2,570.40 / $3,548.13	Facility		$1,071.52	$2,570.40	$3,548.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,884.03 / $3,890.45	Professional		$2,630.27	$2,884.03	$3,890.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $3,388.44 / $3,548.13	Facility		$2,818.38	$3,388.44	$3,548.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,548.13 / $3,548.13	Professional		$3,162.28	$3,548.13	$3,548.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,951.21 / $4,265.80	Facility		$1,819.70	$2,951.21	$4,265.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $3,090.30 / $3,801.89	Professional		$87.10	$3,090.30	$3,801.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,011.87 / $13,489.63	Facility		$2,951.21	$5,011.87	$13,489.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,630.78 / $3,981.07 / $3,981.07	Professional		$3,630.78	$3,981.07	$3,981.07
United Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $2,137.96 / $5,248.07	Facility		$851.14	$2,137.96	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,621.81 / $3,090.30	Professional		$1,445.44	$1,621.81	$3,090.30