Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.69 / $4,684.68 / $8,728.00	Facility		$131.69	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.79 / $150.06 / $204.24	Professional		$110.79	$150.06	$204.24
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.50 / $150.44 / $232.33	Facility		$89.50	$150.44	$232.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.16 / $158.79 / $170.18	Facility		$107.16	$158.79	$170.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.50 / $164.43 / $232.33	Facility		$89.50	$164.43	$232.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,578.09 / $2,064.48 / $2,604.89	Facility		$1,578.09	$2,064.48	$2,604.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00