Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $1,380.38	Facility		$117.49	$117.49	$1,380.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,659.59	Professional		$1,380.38	$1,380.38	$1,659.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,380.38 / $3,235.94	Facility		$1,318.26	$1,380.38	$3,235.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,659.59	Professional		$1,380.38	$1,380.38	$1,659.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $323.59	Professional		$151.36	$257.04	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $1,380.38 / $2,137.96	Facility		$141.25	$1,380.38	$2,137.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $380.19	Professional		$165.96	$251.19	$380.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,698.24 / $2,089.30	Facility		$1,380.38	$1,698.24	$2,089.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $1,412.54 / $2,511.89	Facility		$239.88	$1,412.54	$2,511.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $2,454.71	Professional		$79.43	$125.89	$2,454.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $1,949.84	Professional		$125.89	$158.49	$1,949.84