Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,301.68 / $5,116.62 / $20,400.00	Facility		$1,301.68	$5,116.62	$20,400.00
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 $1,107.32 / $1,297.03 / $1,556.07	Professional		$1,107.32	$1,297.03	$1,556.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $830.55 / $1,075.08 / $1,413.55	Facility		$830.55	$1,075.08	$1,413.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $803.30 / $1,110.85 / $1,194.60	Facility		$803.30	$1,110.85	$1,194.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $830.55 / $1,175.55 / $5,217.00	Facility		$830.55	$1,175.55	$5,217.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $190.90 / $190.90 / $190.90	Facility	AS	$190.90	$190.90	$190.90
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 $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00