Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,004.84 / $7,074.00 / $20,400.00	Facility		$1,004.84	$7,074.00	$20,400.00
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 $959.69 / $1,125.18 / $1,349.90	Professional		$959.69	$1,125.18	$1,349.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $712.78 / $1,014.48 / $1,364.33	Facility		$712.78	$1,014.48	$1,364.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $696.78 / $954.08 / $1,031.13	Facility		$696.78	$954.08	$1,031.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $712.78 / $1,087.44 / $5,217.00	Facility		$712.78	$1,087.44	$5,217.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,715.78 / $10,171.54 / $12,117.15	Facility		$7,715.78	$10,171.54	$12,117.15
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $25,015.00	Facility		$2,155.00	$12,835.00	$25,015.00