Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,567.40 / $2,747.00 / $7,920.26	Facility		$1,567.40	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,251.72 / $1,786.97 / $2,011.95	Professional		$1,251.72	$1,786.97	$2,011.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,162.86 / $1,681.10 / $2,500.17	Facility		$1,162.86	$1,681.10	$2,500.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,122.58 / $1,524.82 / $1,598.62	Facility		$1,122.58	$1,524.82	$1,598.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,162.86 / $1,813.50 / $2,215.89	Facility		$1,162.86	$1,813.50	$2,215.89
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $258.60 / $258.60 / $258.60	Facility	AS	$258.60	$258.60	$258.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,138.22 / $4,138.22 / $4,138.22	Facility		$4,138.22	$4,138.22	$4,138.22
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