Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $807.59 / $1,758.00 / $13,320.00	Facility		$807.59	$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 $873.84 / $1,069.17 / $1,375.05	Professional		$873.84	$1,069.17	$1,375.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $575.64 / $838.04 / $1,406.97	Facility		$575.64	$838.04	$1,406.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $660.08 / $1,033.52 / $1,125.59	Facility		$660.08	$1,033.52	$1,125.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $575.64 / $875.84 / $1,754.38	Facility		$575.64	$875.84	$1,754.38
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