Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $772.49 / $4,684.68 / $8,728.00	Facility		$772.49	$4,684.68	$8,728.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $641.91 / $760.97 / $902.05	Professional		$641.91	$760.97	$902.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $489.75 / $670.96 / $876.35	Facility		$489.75	$670.96	$876.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $514.54 / $684.83 / $724.27	Facility		$514.54	$684.83	$724.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $489.75 / $688.62 / $925.03	Facility		$489.75	$688.62	$925.03
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $537.01 / $537.01 / $537.01	Facility	62	$537.01	$537.01	$537.01
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $137.47 / $137.47 / $137.47	Facility	80	$137.47	$137.47	$137.47
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $116.85 / $116.85 / $116.85	Facility	AS	$116.85	$116.85	$116.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,881.03 / $1,881.03 / $1,881.03	Facility		$1,881.03	$1,881.03	$1,881.03
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00