Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $502.86 / $4,283.46 / $8,728.00	Facility		$502.86	$4,283.46	$8,728.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,089.75 / $1,089.75 / $1,937.44	Facility		$1,089.75	$1,089.75	$1,937.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $428.18 / $629.10 / $1,533.80	Professional		$428.18	$629.10	$1,533.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $346.53 / $692.35 / $1,687.39	Facility		$346.53	$692.35	$1,687.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $490.61 / $1,120.61 / $1,317.22	Facility		$490.61	$1,120.61	$1,317.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $346.53 / $786.40 / $1,909.10	Facility		$346.53	$786.40	$1,909.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,830.49 / $3,730.83 / $4,417.60	Facility		$2,830.49	$3,730.83	$4,417.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,472.00 / $4,880.00 / $7,233.00	Facility		$1,472.00	$4,880.00	$7,233.00