Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $491.38 / $5,649.00 / $15,341.00	Facility		$491.38	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $355.46 / $503.69 / $567.10	Professional		$355.46	$503.69	$567.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $335.13 / $479.24 / $720.53	Facility		$335.13	$479.24	$720.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $321.22 / $433.00 / $460.31	Facility		$321.22	$433.00	$460.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $335.13 / $553.23 / $3,274.00	Facility		$335.13	$553.23	$3,274.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,198.09 / $20,033.77 / $25,621.76	Facility		$15,198.09	$20,033.77	$25,621.76
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00