Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,206.25 / $7,920.26 / $20,400.00	Facility		$1,206.25	$7,920.26	$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 $1,037.78 / $1,216.01 / $1,458.87	Professional		$1,037.78	$1,216.01	$1,458.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $728.64 / $987.84 / $1,305.59	Facility		$728.64	$987.84	$1,305.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $746.13 / $1,025.52 / $1,112.86	Facility		$746.13	$1,025.52	$1,112.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $739.63 / $1,077.90 / $2,748.00	Facility		$739.63	$1,077.90	$2,748.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,873.02 / $21,418.17 / $26,781.36	Facility		$11,873.02	$21,418.17	$26,781.36
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00