Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,083.15 / $5,116.62 / $20,400.00	Facility		$1,083.15	$5,116.62	$20,400.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,040.00 / $1,040.00 / $1,040.00	Facility		$1,040.00	$1,040.00	$1,040.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $931.34 / $1,091.77 / $1,309.81	Professional		$931.34	$1,091.77	$1,309.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $671.26 / $890.64 / $1,172.15	Facility		$671.26	$890.64	$1,172.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $666.19 / $919.33 / $998.30	Facility		$666.19	$919.33	$998.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $683.08 / $978.93 / $5,949.00	Facility		$683.08	$978.93	$5,949.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $158.46 / $158.46 / $158.46	Facility	AS	$158.46	$158.46	$158.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,715.78 / $10,171.54 / $12,117.15	Facility		$7,715.78	$10,171.54	$12,117.15
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