Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,805.11 / $7,920.26 / $20,400.00	Facility		$1,805.11	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,277.34 / $1,841.48 / $2,093.21	Professional		$1,277.34	$1,841.48	$2,093.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,050.83 / $1,643.72 / $2,633.21	Facility		$1,050.83	$1,643.72	$2,633.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,047.35 / $1,461.94 / $1,618.72	Facility		$1,047.35	$1,461.94	$1,618.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,224.75 / $1,887.85 / $5,626.00	Facility		$1,224.75	$1,887.85	$5,626.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,671.70 / $18,246.18 / $21,922.68	Facility		$13,671.70	$18,246.18	$21,922.68
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00