Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $4,786.30 / $15,135.61	Facility		$954.99	$4,786.30	$15,135.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Facility		$4,365.16	$4,365.16	$4,365.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $870.96 / $1,122.02	Professional		$630.96	$870.96	$1,122.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $676.08 / $1,548.82	Facility		$457.09	$676.08	$1,548.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $912.01 / $954.99	Facility		$776.25	$912.01	$954.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $645.65 / $1,122.02	Facility		$426.58	$645.65	$1,122.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,489.63 / $17,782.79 / $21,877.62	Facility		$13,489.63	$17,782.79	$21,877.62
United Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $9,549.93 / $22,908.68	Facility		$1,621.81	$9,549.93	$22,908.68