Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $651.62 / $1,606.50 / $8,728.00	Facility		$651.62	$1,606.50	$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 $697.54 / $826.93 / $980.22	Professional		$697.54	$826.93	$980.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $529.78 / $733.26 / $1,082.03	Facility		$529.78	$733.26	$1,082.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $565.90 / $744.18 / $793.95	Facility		$565.90	$744.18	$793.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $529.78 / $790.42 / $1,012.56	Facility		$529.78	$790.42	$1,012.56
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $586.69 / $586.69 / $586.69	Facility	62	$586.69	$586.69	$586.69
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $150.19 / $150.19 / $150.19	Facility	80	$150.19	$150.19	$150.19
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $127.66 / $127.66 / $127.66	Facility	AS	$127.66	$127.66	$127.66
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00