Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $888.72 / $3,160.00 / $13,746.00	Facility		$888.72	$3,160.00	$13,746.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $986.46 / $1,241.75 / $1,491.98	Professional		$986.46	$1,241.75	$1,491.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $662.29 / $1,034.50 / $1,587.80	Facility		$662.29	$1,034.50	$1,587.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $679.36 / $1,108.84 / $1,234.81	Facility		$679.36	$1,108.84	$1,234.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $662.29 / $1,266.58 / $1,587.80	Facility		$662.29	$1,266.58	$1,587.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,391.79 / $11,229.67 / $14,490.61	Facility		$8,391.79	$11,229.67	$14,490.61
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