Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,046.65 / $7,074.00 / $15,371.22	Facility		$1,046.65	$7,074.00	$15,371.22
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 $992.87 / $1,162.97 / $1,395.23	Professional		$992.87	$1,162.97	$1,395.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $740.08 / $963.48 / $1,269.90	Facility		$740.08	$963.48	$1,269.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $723.36 / $992.94 / $1,067.98	Facility		$723.36	$992.94	$1,067.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $740.55 / $1,051.22 / $5,217.00	Facility		$740.55	$1,051.22	$5,217.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $169.71 / $169.71 / $169.71	Facility	AS	$169.71	$169.71	$169.71
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