Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $489.78 / $794.33	Professional		$354.81	$489.78	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Professional		$436.52	$436.52	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,778.28 / $2,187.76	Professional		$724.44	$1,778.28	$2,187.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $724.44 / $1,023.29	Facility		$575.44	$724.44	$1,023.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $758.58 / $1,047.13	Professional		$707.95	$758.58	$1,047.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $954.99	Facility		$933.25	$933.25	$954.99
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $954.99	Professional		$758.58	$758.58	$954.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $776.25 / $1,202.26	Facility		$478.63	$776.25	$1,202.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $831.76 / $1,000.00	Professional		$87.10	$831.76	$1,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,348.96 / $3,630.78	Facility		$794.33	$1,348.96	$3,630.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,071.52 / $1,071.52	Professional		$977.24	$1,071.52	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,348.96 / $1,778.28	Facility		$537.03	$1,348.96	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $407.38 / $776.25	Professional		$371.54	$407.38	$776.25