Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.05 / $2,747.00 / $20,400.00	Facility		$407.05	$2,747.00	$20,400.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $455.34 / $539.83 / $639.87	Professional		$455.34	$539.83	$639.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $330.94 / $446.77 / $711.52	Facility		$330.94	$446.77	$711.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $339.68 / $457.86 / $517.24	Facility		$339.68	$457.86	$517.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $330.94 / $453.39 / $659.88	Facility		$330.94	$453.39	$659.88
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $382.43 / $382.43 / $382.43	Facility	62	$382.43	$382.43	$382.43
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $97.90 / $97.90 / $97.90	Facility	80	$97.90	$97.90	$97.90
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $83.22 / $83.22 / $83.22	Facility	AS	$83.22	$83.22	$83.22
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00