Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $1,412.54	Facility		$117.49	$117.49	$1,412.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,659.59	Professional		$1,412.54	$1,412.54	$1,659.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,089.30 / $2,754.23	Facility		$1,348.96	$2,089.30	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,698.24	Professional		$1,412.54	$1,412.54	$1,698.24
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 / $1,412.54 / $2,041.74	Facility		$141.25	$1,412.54	$2,041.74
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 / $1,412.54 / $2,137.96	Facility		$1,380.38	$1,412.54	$2,137.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,445.44 / $2,137.96	Facility		$234.42	$1,445.44	$2,137.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $1,949.84	Professional		$79.43	$125.89	$1,949.84
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 / $1,445.44	Professional		$125.89	$158.49	$1,445.44