Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.79 / $2,747.00 / $7,920.26	Facility		$691.79	$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 $546.17 / $717.19 / $871.02	Professional		$546.17	$717.19	$871.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $391.62 / $642.94 / $960.77	Facility		$391.62	$642.94	$960.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $497.10 / $665.34 / $701.49	Facility		$497.10	$665.34	$701.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $402.59 / $720.01 / $960.77	Facility		$402.59	$720.01	$960.77
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $522.96 / $522.96 / $522.96	Facility	62	$522.96	$522.96	$522.96
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $133.88 / $133.88 / $133.88	Facility	80	$133.88	$133.88	$133.88
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $113.80 / $113.80 / $113.80	Facility	AS	$113.80	$113.80	$113.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,820.66 / $1,820.66 / $1,820.66	Facility		$1,820.66	$1,820.66	$1,820.66
United Facility/Professional Facility Modifier Low / Median / High Price $2,151.00 / $15,055.00 / $24,231.00	Facility		$2,151.00	$15,055.00	$24,231.00