Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,050.23 / $2,747.00 / $7,920.26	Facility		$2,050.23	$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 $1,637.83 / $2,150.62 / $2,631.62	Professional		$1,637.83	$2,150.62	$2,631.62
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,116.66 / $1,846.29 / $2,860.10	Facility		$1,116.66	$1,846.29	$2,860.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,300.80 / $1,978.76 / $2,083.69	Facility		$1,300.80	$1,978.76	$2,083.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,204.83 / $2,094.40 / $2,860.10	Facility		$1,204.83	$2,094.40	$2,860.10
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $396.49 / $396.49 / $396.49	Facility	80	$396.49	$396.49	$396.49
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $337.02 / $337.02 / $337.02	Facility	AS	$337.02	$337.02	$337.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,373.26 / $5,373.26 / $5,373.26	Facility		$5,373.26	$5,373.26	$5,373.26
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