Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $599.97 / $1,758.00 / $13,320.00	Facility		$599.97	$1,758.00	$13,320.00
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 $871.14 / $1,096.69 / $1,438.27	Professional		$871.14	$1,096.69	$1,438.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $568.04 / $843.87 / $1,306.06	Facility		$568.04	$843.87	$1,306.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.85 / $1,089.59 / $1,185.90	Facility		$676.85	$1,089.59	$1,185.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $568.04 / $873.14 / $1,570.74	Facility		$568.04	$873.14	$1,570.74
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