Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $277.19 / $2,747.00 / $7,920.26	Facility		$277.19	$2,747.00	$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 $217.90 / $286.12 / $347.28	Professional		$217.90	$286.12	$347.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $157.37 / $258.75 / $387.83	Facility		$157.37	$258.75	$387.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $200.58 / $265.44 / $280.73	Facility		$200.58	$265.44	$280.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $160.85 / $289.44 / $387.83	Facility		$160.85	$289.44	$387.83
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $53.96 / $53.96 / $53.96	Facility	80	$53.96	$53.96	$53.96
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $45.87 / $45.87 / $45.87	Facility	AS	$45.87	$45.87	$45.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $734.66 / $734.66 / $734.66	Facility		$734.66	$734.66	$734.66
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