Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,303.93 / $2,747.00 / $7,920.26	Facility		$1,303.93	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,044.13 / $1,492.78 / $1,680.72	Professional		$1,044.13	$1,492.78	$1,680.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $968.82 / $1,405.81 / $2,082.96	Facility		$968.82	$1,405.81	$2,082.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $932.18 / $1,264.15 / $1,332.63	Facility		$932.18	$1,264.15	$1,332.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $968.82 / $1,510.87 / $1,852.13	Facility		$968.82	$1,510.87	$1,852.13
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $214.70 / $214.70 / $214.70	Facility	AS	$214.70	$214.70	$214.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,428.40 / $3,428.40 / $3,428.40	Facility		$3,428.40	$3,428.40	$3,428.40
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $26,100.00 / $51,981.00	Facility		$3,340.00	$26,100.00	$51,981.00