Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $2,884.03 / $2,884.03	Facility		$616.60	$2,884.03	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $489.78 / $794.33	Professional		$416.87	$489.78	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,862.09	Facility		$1,047.13	$1,047.13	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $676.08 / $831.76	Professional		$645.65	$676.08	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,380.38 / $1,659.59	Professional		$645.65	$1,380.38	$1,659.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $891.25	Facility		$645.65	$645.65	$891.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $707.95 / $870.96	Professional		$645.65	$707.95	$870.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $707.95 / $1,000.00	Facility		$575.44	$707.95	$1,000.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $776.25 / $1,698.24	Facility		$380.19	$776.25	$1,698.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $676.08 / $891.25	Professional		$79.43	$676.08	$891.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,905.46 / $2,511.89	Facility		$954.99	$1,905.46	$2,511.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $588.84 / $776.25	Professional		$478.63	$588.84	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $1,023.29	Facility		$776.25	$776.25	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $776.25	Professional		$269.15	$269.15	$776.25