Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $5,035.59 / $7,920.26	Facility		$2,747.00	$5,035.59	$7,920.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,211.00 / $2,211.00 / $2,211.00	Facility		$2,211.00	$2,211.00	$2,211.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,769.22 / $4,433.76 / $5,296.71	Professional		$3,769.22	$4,433.76	$5,296.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,706.76 / $3,692.10 / $5,027.67	Facility		$2,706.76	$3,692.10	$5,027.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,971.92 / $3,990.09 / $4,290.68	Facility		$2,971.92	$3,990.09	$4,290.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,706.76 / $3,708.26 / $5,434.35	Facility		$2,706.76	$3,708.26	$5,434.35
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $680.91 / $680.91 / $680.91	Facility	AS	$680.91	$680.91	$680.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,874.35 / $10,874.35 / $10,874.35	Facility		$10,874.35	$10,874.35	$10,874.35
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00