Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,597.11 / $5,649.00 / $15,341.00	Facility		$1,597.11	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,142.46 / $1,646.65 / $1,871.39	Professional		$1,142.46	$1,646.65	$1,871.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $924.11 / $1,586.44 / $2,385.21	Facility		$924.11	$1,586.44	$2,385.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,009.76 / $1,389.58 / $1,457.92	Facility		$1,009.76	$1,389.58	$1,457.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,109.40 / $1,827.36 / $3,274.00	Facility		$1,109.40	$1,827.36	$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