Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $5,672.00 / $20,400.00	Facility		$2,747.00	$5,672.00	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.80 / $361.80 / $5,548.00	Professional		$361.80	$361.80	$5,548.00
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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $506.23 / $506.23 / $506.23	Professional		$506.23	$506.23	$506.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $661.73 / $1,380.00 / $2,212.00	Facility		$661.73	$1,380.00	$2,212.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,664.70 / $1,664.70 / $1,644,515.72	Facility		$1,664.70	$1,664.70	$1,644,515.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,153.07 / $2,839.75 / $3,421.41	Facility		$2,153.07	$2,839.75	$3,421.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $473.99 / $1,047.95 / $1,133.09	Professional		$473.99	$1,047.95	$1,133.09
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.00 / $2,261.00 / $4,911.00	Facility		$1,096.00	$2,261.00	$4,911.00