Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,107.90 / $8,878.56 / $32,689.00	Facility		$2,107.90	$8,878.56	$32,689.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,053.95 / $1,158.61 / $1,293.44	Facility	52	$1,053.95	$1,158.61	$1,293.44
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 $1,689.20 / $2,218.07 / $2,718.88	Professional		$1,689.20	$2,218.07	$2,718.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,132.79 / $1,904.02 / $2,965.62	Facility		$1,132.79	$1,904.02	$2,965.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,316.31 / $2,036.80 / $2,155.39	Facility		$1,316.31	$2,036.80	$2,155.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,157.55 / $2,160.36 / $2,965.62	Facility		$1,157.55	$2,160.36	$2,965.62
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $410.24 / $410.24 / $410.24	Facility	80	$410.24	$410.24	$410.24
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $348.70 / $348.70 / $348.70	Facility	AS	$348.70	$348.70	$348.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,669.04 / $6,435.12 / $12,850.27	Facility		$2,669.04	$6,435.12	$12,850.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,331.37 / $17,192.00 / $24,231.00	Facility		$1,331.37	$17,192.00	$24,231.00