Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,771.42 / $7,920.26 / $20,400.00	Facility		$1,771.42	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,634.44 / $1,933.62 / $2,319.79	Professional		$1,634.44	$1,933.62	$2,319.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,132.31 / $1,583.48 / $2,040.85	Facility		$1,132.31	$1,583.48	$2,040.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,149.23 / $1,589.24 / $1,772.82	Facility		$1,149.23	$1,589.24	$1,772.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,207.00 / $1,735.10 / $5,217.00	Facility		$1,207.00	$1,735.10	$5,217.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $287.87 / $287.87 / $287.87	Facility	AS	$287.87	$287.87	$287.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,715.78 / $10,171.54 / $12,117.15	Facility		$7,715.78	$10,171.54	$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