Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.89 / $12,658.06 / $21,735.00	Facility		$1,230.89	$12,658.06	$21,735.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $24,513.00 / $24,930.00 / $28,211.72	Facility	50	$24,513.00	$24,930.00	$28,211.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,250.41 / $3,250.41 / $4,924.56	Facility		$3,250.41	$3,250.41	$4,924.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $901.38 / $1,183.59 / $1,459.72	Professional		$901.38	$1,183.59	$1,459.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $634.88 / $1,016.18 / $1,525.39	Facility		$634.88	$1,016.18	$1,525.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $779.08 / $1,059.94 / $1,147.04	Facility		$779.08	$1,059.94	$1,147.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $682.87 / $1,122.97 / $1,972.51	Facility		$682.87	$1,122.97	$1,972.51
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $217.26 / $217.26 / $217.26	Facility	80	$217.26	$217.26	$217.26
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $184.67 / $184.67 / $184.67	Facility	AS	$184.67	$184.67	$184.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,624.30 / $18,659.50 / $21,600.03	Facility		$13,624.30	$18,659.50	$21,600.03
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $20,436.45 / $27,989.25 / $32,400.05	Facility	50	$20,436.45	$27,989.25	$32,400.05
United Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $17,375.00 / $26,255.00	Facility		$2,800.00	$17,375.00	$26,255.00