Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,410.58 / $5,649.00 / $15,341.00	Facility		$1,410.58	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,019.83 / $1,458.66 / $1,678.79	Professional		$1,019.83	$1,458.66	$1,678.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $646.62 / $1,251.23 / $2,101.35	Facility		$646.62	$1,251.23	$2,101.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $733.15 / $1,088.08 / $1,266.30	Facility		$733.15	$1,088.08	$1,266.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $941.85 / $1,414.40 / $3,274.00	Facility		$941.85	$1,414.40	$3,274.00
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