Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $957.31 / $3,213.00 / $8,728.00	Facility		$957.31	$3,213.00	$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 $853.45 / $1,011.73 / $1,199.32	Professional		$853.45	$1,011.73	$1,199.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $664.56 / $896.94 / $1,368.04	Facility		$664.56	$896.94	$1,368.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $702.04 / $910.50 / $976.19	Facility		$702.04	$910.50	$976.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $664.56 / $950.32 / $1,368.04	Facility		$664.56	$950.32	$1,368.04
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $734.74 / $734.74 / $734.74	Facility	62	$734.74	$734.74	$734.74
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $188.09 / $188.09 / $188.09	Facility	80	$188.09	$188.09	$188.09
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $159.88 / $159.88 / $159.88	Facility	AS	$159.88	$159.88	$159.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,583.71 / $11,248.43 / $54,156.35	Facility		$2,583.71	$11,248.43	$54,156.35
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