Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,380.38 / $7,943.28	Facility		$776.25	$1,380.38	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,023.29 / $1,174.90	Professional		$501.19	$1,023.29	$1,174.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $831.76 / $1,659.59	Facility		$549.54	$831.76	$1,659.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,071.52 / $1,148.15	Facility		$851.14	$1,071.52	$1,148.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $794.33 / $1,380.38	Facility		$575.44	$794.33	$1,380.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Facility		$2,951.21	$2,951.21	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $10,232.93 / $37,153.52	Facility		$2,454.71	$10,232.93	$37,153.52