Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $539.52 / $2,305.60 / $7,920.26	Facility		$539.52	$2,305.60	$7,920.26
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 $571.33 / $678.41 / $802.87	Professional		$571.33	$678.41	$802.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $438.64 / $600.94 / $810.81	Facility		$438.64	$600.94	$810.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $465.60 / $610.53 / $652.12	Facility		$465.60	$610.53	$652.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $438.64 / $627.26 / $830.64	Facility		$438.64	$627.26	$830.64
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $481.80 / $481.80 / $481.80	Facility	62	$481.80	$481.80	$481.80
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $123.34 / $123.34 / $123.34	Facility	80	$123.34	$123.34	$123.34
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $104.84 / $104.84 / $104.84	Facility	AS	$104.84	$104.84	$104.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,710.63 / $1,710.63 / $1,710.63	Facility		$1,710.63	$1,710.63	$1,710.63
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00