Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $661.00 / $3,771.38 / $16,653.56	Facility		$661.00	$3,771.38	$16,653.56
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 $860.94 / $1,008.43 / $1,209.83	Professional		$860.94	$1,008.43	$1,209.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $634.50 / $841.80 / $1,112.65	Facility		$634.50	$841.80	$1,112.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $631.29 / $859.40 / $925.27	Facility		$631.29	$859.40	$925.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $642.85 / $919.28 / $5,217.00	Facility		$642.85	$919.28	$5,217.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $172.80 / $172.80 / $172.80	Facility	80	$172.80	$172.80	$172.80
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $146.88 / $146.88 / $146.88	Facility	AS	$146.88	$146.88	$146.88
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