Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $906.72 / $3,107.00 / $20,400.00	Facility		$906.72	$3,107.00	$20,400.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,643.00 / $1,643.00 / $1,643.00	Facility		$1,643.00	$1,643.00	$1,643.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $869.82 / $1,021.98 / $1,226.08	Professional		$869.82	$1,021.98	$1,226.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $621.62 / $817.20 / $1,093.09	Facility		$621.62	$817.20	$1,093.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $621.61 / $857.46 / $935.32	Facility		$621.61	$857.46	$935.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $632.65 / $905.93 / $8,647.00	Facility		$632.65	$905.93	$8,647.00
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 $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00