Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $892.89 / $4,283.46 / $8,728.00	Facility		$892.89	$4,283.46	$8,728.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,131.80 / $1,131.80 / $1,937.44	Facility		$1,131.80	$1,131.80	$1,937.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $770.70 / $1,005.91 / $1,291.80	Professional		$770.70	$1,005.91	$1,291.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $500.58 / $827.58 / $1,329.00	Facility		$500.58	$827.58	$1,329.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $589.76 / $972.84 / $1,055.25	Facility		$589.76	$972.84	$1,055.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $512.55 / $882.67 / $1,380.07	Facility		$512.55	$882.67	$1,380.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,539.74 / $4,743.41 / $5,709.03	Facility		$3,539.74	$4,743.41	$5,709.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,472.00 / $4,880.00 / $7,233.00	Facility		$1,472.00	$4,880.00	$7,233.00