Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,218.19 / $7,074.00 / $20,400.00	Facility		$1,218.19	$7,074.00	$20,400.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,211.00 / $2,211.00 / $2,211.00	Facility		$2,211.00	$2,211.00	$2,211.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,043.07 / $1,221.77 / $1,465.77	Professional		$1,043.07	$1,221.77	$1,465.77
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $773.87 / $1,082.14 / $1,505.03	Facility		$773.87	$1,082.14	$1,505.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $762.60 / $1,041.84 / $1,119.57	Facility		$762.60	$1,041.84	$1,119.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $773.87 / $1,129.59 / $1,505.03	Facility		$773.87	$1,129.59	$1,505.03
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $177.35 / $177.35 / $177.35	Facility	AS	$177.35	$177.35	$177.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,868.81 / $5,124.10 / $6,421.06	Facility		$3,868.81	$5,124.10	$6,421.06
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,113.00	Facility		$1,981.00	$9,074.00	$12,113.00