Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $4,677.35 / $14,125.38	Facility		$1,230.27	$4,677.35	$14,125.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,445.44 / $1,737.80	Professional		$1,096.48	$1,445.44	$1,737.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,122.02 / $1,905.46	Facility		$660.69	$1,122.02	$1,905.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,202.26 / $1,258.93	Facility		$912.01	$1,202.26	$1,258.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,071.52 / $1,513.56	Facility		$660.69	$1,071.52	$1,513.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,762.47 / $10,232.93 / $12,302.69	Facility		$7,762.47	$10,232.93	$12,302.69
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $12,882.50 / $26,302.68	Facility		$2,137.96	$12,882.50	$26,302.68