Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,561.34 / $2,747.00 / $7,920.26	Facility		$1,561.34	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,246.59 / $1,775.14 / $1,998.63	Professional		$1,246.59	$1,775.14	$1,998.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,155.35 / $1,801.78 / $2,484.02	Facility		$1,155.35	$1,801.78	$2,484.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,127.43 / $1,518.58 / $1,591.92	Facility		$1,127.43	$1,518.58	$1,591.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,155.35 / $1,902.36 / $2,484.02	Facility		$1,155.35	$1,902.36	$2,484.02
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $257.39 / $257.39 / $257.39	Facility	AS	$257.39	$257.39	$257.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,147.10 / $4,147.10 / $4,147.10	Facility		$4,147.10	$4,147.10	$4,147.10
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00