Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $695.73 / $4,704.00 / $8,728.00	Facility		$695.73	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $500.55 / $709.63 / $798.97	Professional		$500.55	$709.63	$798.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $373.50 / $529.54 / $1,004.44	Facility		$373.50	$529.54	$1,004.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $317.52 / $521.78 / $637.16	Facility		$317.52	$521.78	$637.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $416.07 / $615.52 / $2,724.00	Facility		$416.07	$615.52	$2,724.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,539.74 / $4,494.80 / $5,709.03	Facility		$3,539.74	$4,494.80	$5,709.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00