Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,430.57 / $8,878.56 / $20,400.00	Facility		$1,430.57	$8,878.56	$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 $1,219.33 / $1,428.24 / $1,713.48	Professional		$1,219.33	$1,428.24	$1,713.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $904.50 / $1,184.20 / $1,557.20	Facility		$904.50	$1,184.20	$1,557.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $889.54 / $1,222.08 / $1,318.56	Facility		$889.54	$1,222.08	$1,318.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $909.50 / $1,282.08 / $3,397.00	Facility		$909.50	$1,282.08	$3,397.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $210.01 / $210.01 / $210.01	Facility	AS	$210.01	$210.01	$210.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,914.95 / $21,418.17 / $26,781.36	Facility		$8,914.95	$21,418.17	$26,781.36
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00