Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,045.30 / $3,874.20 / $13,320.00	Facility		$1,045.30	$3,874.20	$13,320.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,357.36 / $1,590.50 / $1,908.15	Professional		$1,357.36	$1,590.50	$1,908.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,008.80 / $1,395.83 / $1,823.25	Facility		$1,008.80	$1,395.83	$1,823.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,026.17 / $1,403.65 / $1,599.29	Facility		$1,026.17	$1,403.65	$1,599.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,092.83 / $1,547.51 / $5,217.00	Facility		$1,092.83	$1,547.51	$5,217.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $260.13 / $260.13 / $260.13	Facility	AS	$260.13	$260.13	$260.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,715.78 / $9,638.43 / $12,117.15	Facility		$7,715.78	$9,638.43	$12,117.15
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