Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,748.64 / $4,704.00 / $8,728.00	Facility		$1,748.64	$4,704.00	$8,728.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $451.00 / $451.00 / $451.00	Facility		$451.00	$451.00	$451.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $791.85 / $1,627.13 / $1,825.96	Professional		$791.85	$1,627.13	$1,825.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $791.85 / $1,227.36 / $1,791.04	Facility		$791.85	$1,227.36	$1,791.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $895.92 / $1,267.64 / $1,562.44	Facility		$895.92	$1,267.64	$1,562.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $893.74 / $1,692.08 / $3,023.00	Facility		$893.74	$1,692.08	$3,023.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,813.93 / $11,944.47 / $14,473.89	Facility		$8,813.93	$11,944.47	$14,473.89
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00