Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $883.36 / $4,962.67 / $15,341.00	Facility		$883.36	$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 $740.22 / $867.03 / $1,040.19	Professional		$740.22	$867.03	$1,040.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $553.26 / $778.80 / $1,036.80	Facility		$553.26	$778.80	$1,036.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $565.90 / $779.28 / $813.28	Facility		$565.90	$779.28	$813.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $582.38 / $827.71 / $2,919.00	Facility		$582.38	$827.71	$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 $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00