Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $879.90 / $4,684.68 / $8,728.00	Facility		$879.90	$4,684.68	$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 $399.89 / $822.34 / $922.12	Professional		$399.89	$822.34	$922.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $399.89 / $619.83 / $943.19	Facility		$399.89	$619.83	$943.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $473.83 / $672.01 / $789.93	Facility		$473.83	$672.01	$789.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $466.12 / $854.90 / $3,023.00	Facility		$466.12	$854.90	$3,023.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,698.81 / $7,379.02 / $8,723.76	Facility		$5,698.81	$7,379.02	$8,723.76
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