Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $631.59 / $4,684.68 / $8,728.00	Facility		$631.59	$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 $454.87 / $666.53 / $1,041.23	Professional		$454.87	$666.53	$1,041.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $363.83 / $616.67 / $1,047.85	Facility		$363.83	$616.67	$1,047.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $529.20 / $824.26 / $910.52	Facility		$529.20	$824.26	$910.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $390.78 / $765.90 / $2,573.00	Facility		$390.78	$765.90	$2,573.00
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