Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.50 / $5,649.00 / $15,341.00	Facility		$812.50	$5,649.00	$15,341.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $604.00 / $604.00 / $604.00	Facility		$604.00	$604.00	$604.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $373.25 / $774.75 / $860.83	Professional		$373.25	$774.75	$860.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $380.31 / $578.54 / $1,035.75	Facility		$380.31	$578.54	$1,035.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $448.06 / $698.14 / $734.32	Facility		$448.06	$698.14	$734.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $452.48 / $854.39 / $4,681.00	Facility		$452.48	$854.39	$4,681.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,454.55 / $6,944.43 / $8,747.84	Facility		$5,454.55	$6,944.43	$8,747.84
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