Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $236.39 / $2,747.00 / $7,920.26	Facility		$236.39	$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 $186.43 / $244.79 / $297.32	Professional		$186.43	$244.79	$297.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $127.24 / $218.73 / $330.44	Facility		$127.24	$218.73	$330.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $171.03 / $227.10 / $238.52	Facility		$171.03	$227.10	$238.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $133.87 / $243.82 / $330.44	Facility		$133.87	$243.82	$330.44
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $45.87 / $45.87 / $45.87	Facility	80	$45.87	$45.87	$45.87
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $38.99 / $38.99 / $38.99	Facility	AS	$38.99	$38.99	$38.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $626.41 / $626.41 / $626.41	Facility		$626.41	$626.41	$626.41
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