Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,807.07 / $2,747.00 / $7,920.26	Facility		$1,807.07	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,438.16 / $2,051.53 / $2,309.82	Professional		$1,438.16	$2,051.53	$2,309.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,277.65 / $1,941.73 / $2,880.55	Facility		$1,277.65	$1,941.73	$2,880.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,299.43 / $1,745.25 / $1,835.13	Facility		$1,299.43	$1,745.25	$1,835.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,339.79 / $2,089.40 / $2,589.83	Facility		$1,339.79	$2,089.40	$2,589.83
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $297.70 / $297.70 / $297.70	Facility	AS	$297.70	$297.70	$297.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,768.16 / $4,768.16 / $4,768.16	Facility		$4,768.16	$4,768.16	$4,768.16
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