Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $823.06 / $2,747.00 / $15,316.67	Facility		$823.06	$2,747.00	$15,316.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $962.78 / $1,215.34 / $1,456.18	Professional		$962.78	$1,215.34	$1,456.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $669.16 / $1,043.29 / $1,562.30	Facility		$669.16	$1,043.29	$1,562.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $671.34 / $1,108.79 / $1,204.66	Facility		$671.34	$1,108.79	$1,204.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $669.16 / $1,264.92 / $1,562.30	Facility		$669.16	$1,264.92	$1,562.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,573.85 / $5,897.44 / $7,222.39	Facility		$4,573.85	$5,897.44	$7,222.39
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00