Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $671.26 / $2,747.00 / $7,920.26	Facility		$671.26	$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 $529.66 / $695.51 / $861.21	Professional		$529.66	$695.51	$861.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $398.05 / $725.96 / $1,015.92	Facility		$398.05	$725.96	$1,015.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $470.40 / $641.19 / $697.93	Facility		$470.40	$641.19	$697.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $401.88 / $777.82 / $1,100.58	Facility		$401.88	$777.82	$1,100.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,763.99 / $12,103.13 / $13,092.93	Facility		$8,763.99	$12,103.13	$13,092.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,895.00 / $11,770.00 / $26,404.00	Facility		$1,895.00	$11,770.00	$26,404.00