Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,767.92 / $4,962.67 / $15,341.00	Facility		$1,767.92	$4,962.67	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,649.36 / $2,039.21 / $2,490.02	Professional		$1,649.36	$2,039.21	$2,490.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,122.27 / $1,530.31 / $2,467.65	Facility		$1,122.27	$1,530.31	$2,467.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,291.15 / $1,826.42 / $3,184.02	Facility		$1,291.15	$1,826.42	$3,184.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,150.96 / $1,934.67 / $4,681.00	Facility		$1,150.96	$1,934.67	$4,681.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,391.79 / $11,115.96 / $14,408.62	Facility		$8,391.79	$11,115.96	$14,408.62
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00