Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,143.76 / $20,780.00 / $23,856.49	Facility		$1,143.76	$20,780.00	$23,856.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,375.60 / $4,375.60 / $4,924.56	Facility		$4,375.60	$4,375.60	$4,924.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $920.80 / $1,209.09 / $1,491.97	Professional		$920.80	$1,209.09	$1,491.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $625.89 / $1,037.99 / $1,569.82	Facility		$625.89	$1,037.99	$1,569.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $801.15 / $1,091.43 / $1,171.16	Facility		$801.15	$1,091.43	$1,171.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $689.59 / $1,158.90 / $2,013.98	Facility		$689.59	$1,158.90	$2,013.98
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $222.40 / $222.40 / $222.40	Facility	80	$222.40	$222.40	$222.40
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $189.04 / $189.04 / $189.04	Facility	AS	$189.04	$189.04	$189.04
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
United Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $17,375.00 / $26,255.00	Facility		$2,800.00	$17,375.00	$26,255.00