Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,522.25 / $7,920.26 / $20,400.00	Facility		$4,522.25	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,607.75 / $4,460.47 / $5,345.08	Professional		$3,607.75	$4,460.47	$5,345.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,669.37 / $3,391.68 / $6,446.80	Facility		$2,669.37	$3,391.68	$6,446.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,191.89 / $4,342.00 / $4,540.59	Facility		$3,191.89	$4,342.00	$4,540.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,688.88 / $3,776.38 / $6,446.80	Facility		$2,688.88	$3,776.38	$6,446.80
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $3,371.09 / $3,371.09 / $3,371.09	Facility	62	$3,371.09	$3,371.09	$3,371.09
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $863.00 / $863.00 / $863.00	Facility	80	$863.00	$863.00	$863.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $733.55 / $733.55 / $733.55	Facility	AS	$733.55	$733.55	$733.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,750.95 / $11,750.95 / $11,750.95	Facility		$11,750.95	$11,750.95	$11,750.95
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