Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $997.95 / $5,116.62 / $13,320.00	Facility		$997.95	$5,116.62	$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 $950.19 / $1,112.98 / $1,335.26	Professional		$950.19	$1,112.98	$1,335.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $702.53 / $932.19 / $1,225.70	Facility		$702.53	$932.19	$1,225.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $692.35 / $957.43 / $1,025.09	Facility		$692.35	$957.43	$1,025.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $702.53 / $1,004.62 / $5,217.00	Facility		$702.53	$1,004.62	$5,217.00
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