Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $904.14 / $4,962.67 / $15,341.00	Facility		$904.14	$4,962.67	$15,341.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.00 / $736.00 / $736.00	Facility		$736.00	$736.00	$736.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $863.57 / $1,012.52 / $1,214.74	Professional		$863.57	$1,012.52	$1,214.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $609.24 / $829.44 / $1,096.50	Facility		$609.24	$829.44	$1,096.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $630.33 / $854.25 / $927.28	Facility		$630.33	$854.25	$927.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $627.11 / $906.61 / $2,919.00	Facility		$627.11	$906.61	$2,919.00
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