Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $741.31	Facility		$117.49	$117.49	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $891.25	Professional		$741.31	$741.31	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,380.38 / $1,862.09	Facility		$691.83	$1,380.38	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $891.25	Professional		$741.31	$741.31	$891.25
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 / $741.31 / $1,047.13	Facility		$141.25	$741.31	$1,047.13
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 $741.31 / $812.83 / $1,096.48	Facility		$741.31	$812.83	$1,096.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $758.58 / $1,949.84	Facility		$239.88	$758.58	$1,949.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $1,318.26	Professional		$79.43	$125.89	$1,318.26
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 / $1,862.09	Professional		$125.89	$158.49	$1,862.09