Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $1,047.13	Facility		$117.49	$117.49	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,047.13 / $1,230.27	Professional		$912.01	$1,047.13	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $602.56 / $1,047.13	Facility		$426.58	$602.56	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,148.15	Professional		$1,047.13	$1,047.13	$1,148.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $323.59	Professional		$169.82	$263.03	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $1,047.13 / $1,479.11	Facility		$141.25	$1,047.13	$1,479.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $363.08	Professional		$169.82	$251.19	$363.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $1,047.13 / $1,318.26	Facility		$302.00	$1,047.13	$1,318.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,047.13 / $1,445.44	Facility		$234.42	$1,047.13	$1,445.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $426.58	Professional		$79.43	$125.89	$426.58
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 / $1,000.00	Professional		$125.89	$158.49	$1,000.00