Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $1,786.34 / $7,920.26	Facility		$765.00	$1,786.34	$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 $1,344.55 / $1,593.95 / $1,889.43	Professional		$1,344.55	$1,593.95	$1,889.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,022.53 / $1,400.87 / $1,841.13	Facility		$1,022.53	$1,400.87	$1,841.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,082.85 / $1,434.46 / $1,528.27	Facility		$1,082.85	$1,434.46	$1,528.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,022.53 / $1,434.51 / $1,948.75	Facility		$1,022.53	$1,434.51	$1,948.75
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,129.22 / $1,129.22 / $1,129.22	Facility	62	$1,129.22	$1,129.22	$1,129.22
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $289.08 / $289.08 / $289.08	Facility	80	$289.08	$289.08	$289.08
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $245.72 / $245.72 / $245.72	Facility	AS	$245.72	$245.72	$245.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,967.83 / $3,967.83 / $3,967.83	Facility		$3,967.83	$3,967.83	$3,967.83
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