Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,058.83 / $4,704.00 / $8,728.00	Facility		$1,058.83	$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 $482.81 / $1,000.88 / $1,113.33	Professional		$482.81	$1,000.88	$1,113.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $482.81 / $765.90 / $1,260.67	Facility		$482.81	$765.90	$1,260.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $636.02 / $893.11 / $954.75	Facility		$636.02	$893.11	$954.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $565.38 / $1,079.73 / $3,023.00	Facility		$565.38	$1,079.73	$3,023.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,698.81 / $6,992.27 / $8,723.76	Facility		$5,698.81	$6,992.27	$8,723.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00