Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,283.40 / $1,954.73 / $13,746.00	Facility		$1,283.40	$1,954.73	$13,746.00
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 $1,210.82 / $1,492.39 / $1,909.17	Professional		$1,210.82	$1,492.39	$1,909.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $791.50 / $1,196.78 / $1,778.29	Facility		$791.50	$1,196.78	$1,778.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $913.99 / $1,450.58 / $1,587.23	Facility		$913.99	$1,450.58	$1,587.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $800.35 / $1,231.40 / $2,175.16	Facility		$800.35	$1,231.40	$2,175.16
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $253.91 / $253.91 / $253.91	Facility	AS	$253.91	$253.91	$253.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $16,860.72 / $22,602.85 / $26,781.36	Facility		$16,860.72	$22,602.85	$26,781.36
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