Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $4,684.68 / $8,728.00	Facility		$988.00	$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 $941.49 / $1,106.42 / $1,327.39	Professional		$941.49	$1,106.42	$1,327.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $624.08 / $878.40 / $1,182.34	Facility		$624.08	$878.40	$1,182.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $669.58 / $925.94 / $1,012.37	Facility		$669.58	$925.94	$1,012.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $624.08 / $912.02 / $1,277.71	Facility		$624.08	$912.02	$1,277.71
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 $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00