Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $884.22 / $5,116.62 / $15,341.00	Facility		$884.22	$5,116.62	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $635.14 / $910.57 / $1,036.57	Professional		$635.14	$910.57	$1,036.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $545.75 / $805.92 / $1,173.35	Facility		$545.75	$805.92	$1,173.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $572.67 / $773.72 / $826.20	Facility		$572.67	$773.72	$826.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $545.75 / $1,007.64 / $6,008.00	Facility		$545.75	$1,007.64	$6,008.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,573.85 / $5,897.44 / $7,048.47	Facility		$4,573.85	$5,897.44	$7,048.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00