Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $908.33 / $4,962.67 / $15,341.00	Facility		$908.33	$4,962.67	$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 $561.69 / $965.34 / $1,281.28	Professional		$561.69	$965.34	$1,281.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $507.21 / $795.96 / $1,299.78	Facility		$507.21	$795.96	$1,299.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $618.85 / $994.29 / $1,106.83	Facility		$618.85	$994.29	$1,106.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $523.20 / $940.41 / $3,065.00	Facility		$523.20	$940.41	$3,065.00
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