Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $3,213.00 / $24,734.70	Facility		$765.00	$3,213.00	$24,734.70
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 $689.26 / $817.11 / $968.59	Professional		$689.26	$817.11	$968.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $524.32 / $718.32 / $943.65	Facility		$524.32	$718.32	$943.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $555.72 / $735.35 / $783.90	Facility		$555.72	$735.35	$783.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $524.32 / $734.05 / $998.83	Facility		$524.32	$734.05	$998.83
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $578.66 / $578.66 / $578.66	Facility	62	$578.66	$578.66	$578.66
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $148.13 / $148.13 / $148.13	Facility	80	$148.13	$148.13	$148.13
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $125.92 / $125.92 / $125.92	Facility	AS	$125.92	$125.92	$125.92
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