Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,573.66 / $2,747.00 / $7,920.26	Facility		$1,573.66	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,265.08 / $1,803.32 / $2,030.35	Professional		$1,265.08	$1,803.32	$2,030.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,165.09 / $1,816.97 / $2,504.96	Facility		$1,165.09	$1,816.97	$2,504.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,137.11 / $1,541.10 / $1,646.45	Facility		$1,137.11	$1,541.10	$1,646.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,165.09 / $1,918.96 / $2,265.87	Facility		$1,165.09	$1,918.96	$2,265.87
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $260.35 / $260.35 / $260.35	Facility	AS	$260.35	$260.35	$260.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,166.63 / $4,166.63 / $4,166.63	Facility		$4,166.63	$4,166.63	$4,166.63
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