Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.87 / $3,185.85 / $20,400.00	Facility		$73.87	$3,185.85	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,917.60 / $1,917.60 / $7,084.00	Professional		$1,917.60	$1,917.60	$7,084.00
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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,247.03 / $3,247.03 / $3,247.03	Professional		$3,247.03	$3,247.03	$3,247.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,497.59 / $8,714.00 / $13,964.00	Facility		$5,497.59	$8,714.00	$13,964.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,664.70 / $1,664.70 / $1,647,300.28	Facility		$1,664.70	$1,664.70	$1,647,300.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,624.30 / $18,659.50 / $21,600.03	Facility		$13,624.30	$18,659.50	$21,600.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,851.10 / $6,572.57 / $7,106.61	Professional		$3,851.10	$6,572.57	$7,106.61
United Facility/Professional Facility Modifier Low / Median / High Price $2,151.00 / $15,055.00 / $24,231.00	Facility		$2,151.00	$15,055.00	$24,231.00