Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $4,786.30 / $8,709.64	Facility		$208.93	$4,786.30	$8,709.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $257.04	Professional		$169.82	$199.53	$257.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $162.18 / $269.15	Facility		$95.50	$162.18	$269.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $204.17 / $213.80	Facility		$158.49	$204.17	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $162.18 / $263.03	Facility		$100.00	$162.18	$263.03
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $18.20 / $18.20 / $18.20	Facility	AS	$18.20	$18.20	$18.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,258.93 / $1,584.89	Facility		$870.96	$1,258.93	$1,584.89
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $2,187.76 / $6,165.95	Facility		$389.05	$2,187.76	$6,165.95