Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $732.81 / $4,684.68 / $8,728.00	Facility		$732.81	$4,684.68	$8,728.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $628.00 / $739.87 / $887.64	Professional		$628.00	$739.87	$887.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $428.42 / $580.32 / $784.55	Facility		$428.42	$580.32	$784.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $445.74 / $616.40 / $672.68	Facility		$445.74	$616.40	$672.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $433.00 / $651.04 / $2,450.00	Facility		$433.00	$651.04	$2,450.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,820.30 / $4,901.89 / $6,365.28	Facility		$3,820.30	$4,901.89	$6,365.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00