Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,491.85 / $2,749.66 / $3,073.21	Facility		$2,491.85	$2,749.66	$3,073.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,315.91 / $2,718.26 / $3,254.44	Professional		$2,315.91	$2,718.26	$3,254.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,749.95 / $2,277.00 / $3,030.25	Facility		$1,749.95	$2,277.00	$3,030.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,749.53 / $2,368.48 / $2,531.92	Facility		$1,749.53	$2,368.48	$2,531.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,749.95 / $2,409.66 / $3,220.45	Facility		$1,749.95	$2,409.66	$3,220.45
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $406.03 / $406.03 / $406.03	Facility	AS	$406.03	$406.03	$406.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $18,472.14 / $39,875.19 / $51,188.76	Facility		$18,472.14	$39,875.19	$51,188.76