Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $2,903.00 / $8,728.00	Facility		$765.00	$2,903.00	$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 $1,331.76 / $1,578.99 / $1,871.46	Professional		$1,331.76	$1,578.99	$1,871.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,018.79 / $1,395.74 / $1,838.70	Facility		$1,018.79	$1,395.74	$1,838.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,078.50 / $1,420.98 / $1,517.08	Facility		$1,078.50	$1,420.98	$1,517.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,018.79 / $1,432.44 / $1,934.16	Facility		$1,018.79	$1,432.44	$1,934.16
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,123.19 / $1,123.19 / $1,123.19	Facility	62	$1,123.19	$1,123.19	$1,123.19
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $287.54 / $287.54 / $287.54	Facility	80	$287.54	$287.54	$287.54
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $244.41 / $244.41 / $244.41	Facility	AS	$244.41	$244.41	$244.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,955.44 / $3,955.44 / $3,955.44	Facility		$3,955.44	$3,955.44	$3,955.44
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