Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $1,445.44	Facility		$117.49	$117.49	$1,445.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,819.70	Professional		$1,445.44	$1,445.44	$1,819.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $2,187.76 / $3,311.31	Facility		$1,380.38	$2,187.76	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,698.24	Professional		$1,445.44	$1,445.44	$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 / $1,445.44 / $2,089.30	Facility		$141.25	$1,445.44	$2,089.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $537.03	Professional		$169.82	$251.19	$537.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,445.44 / $2,187.76	Facility		$891.25	$1,445.44	$2,187.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,479.11 / $2,818.38	Facility		$234.42	$1,479.11	$2,818.38
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 / $2,511.89	Professional		$125.89	$158.49	$2,511.89