Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $839.32 / $2,747.00 / $8,728.00	Facility		$839.32	$2,747.00	$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 $895.24 / $1,061.38 / $1,258.04	Professional		$895.24	$1,061.38	$1,258.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $682.38 / $884.12 / $1,467.12	Facility		$682.38	$884.12	$1,467.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $686.15 / $955.17 / $1,012.37	Facility		$686.15	$955.17	$1,012.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $682.38 / $921.21 / $1,292.30	Facility		$682.38	$921.21	$1,292.30
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $163.05 / $163.05 / $163.05	Facility	AS	$163.05	$163.05	$163.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,612.12 / $2,612.12 / $2,612.12	Facility		$2,612.12	$2,612.12	$2,612.12
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