Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $282.81 / $1,734.00 / $7,920.26	Facility		$282.81	$1,734.00	$7,920.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,664.70 / $1,664.70 / $1,664.70	Facility		$1,664.70	$1,664.70	$1,664.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $241.94 / $317.69 / $385.18	Professional		$241.94	$317.69	$385.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $171.33 / $309.22 / $449.50	Facility		$171.33	$309.22	$449.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $223.35 / $294.73 / $312.89	Facility		$223.35	$294.73	$312.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $179.43 / $338.57 / $438.73	Facility		$179.43	$338.57	$438.73
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $60.13 / $60.13 / $60.13	Facility	80	$60.13	$60.13	$60.13
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $51.11 / $51.11 / $51.11	Facility	AS	$51.11	$51.11	$51.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $819.85 / $819.85 / $819.85	Facility		$819.85	$819.85	$819.85
United Facility/Professional Facility Modifier Low / Median / High Price $1,345.00 / $7,664.00 / $31,303.00	Facility		$1,345.00	$7,664.00	$31,303.00