Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $766.82 / $4,684.68 / $8,728.00	Facility		$766.82	$4,684.68	$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 $636.37 / $754.39 / $894.26	Professional		$636.37	$754.39	$894.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $461.46 / $665.48 / $869.55	Facility		$461.46	$665.48	$869.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $509.69 / $678.90 / $720.80	Facility		$509.69	$678.90	$720.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $475.55 / $680.05 / $917.31	Facility		$475.55	$680.05	$917.31
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $531.99 / $531.99 / $531.99	Facility	62	$531.99	$531.99	$531.99
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $136.19 / $136.19 / $136.19	Facility	80	$136.19	$136.19	$136.19
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $115.76 / $115.76 / $115.76	Facility	AS	$115.76	$115.76	$115.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,865.02 / $1,865.02 / $1,865.02	Facility		$1,865.02	$1,865.02	$1,865.02
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