Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $1,230.27	Facility		$117.49	$117.49	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,548.82	Professional		$1,230.27	$1,230.27	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $2,089.30	Facility		$1,174.90	$1,659.59	$2,089.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,380.38	Professional		$1,230.27	$1,230.27	$1,380.38
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 / $1,230.27 / $1,778.28	Facility		$141.25	$1,230.27	$1,778.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $660.69	Professional		$169.82	$251.19	$660.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,230.27 / $1,862.09	Facility		$1,202.26	$1,230.27	$1,862.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,230.27 / $1,862.09	Facility		$234.42	$1,230.27	$1,862.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $1,819.70	Professional		$79.43	$125.89	$1,819.70
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 / $1,412.54	Professional		$125.89	$158.49	$1,412.54