Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,621.81 / $12,022.64	Facility		$870.96	$1,621.81	$12,022.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,047.13 / $1,621.81	Professional		$707.95	$1,047.13	$1,621.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $870.96 / $1,905.46	Facility		$478.63	$870.96	$1,905.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $1,288.25	Facility		$776.25	$1,122.02	$1,288.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $812.83 / $1,348.96	Facility		$489.78	$812.83	$1,348.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $8,912.51 / $10,715.19	Facility		$6,606.93	$8,912.51	$10,715.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $9,549.93 / $12,882.50	Facility		$1,995.26	$9,549.93	$12,882.50