Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,135.95 / $2,747.00 / $7,920.26	Facility		$1,135.95	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $905.84 / $1,293.01 / $1,471.92	Professional		$905.84	$1,293.01	$1,471.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $761.87 / $1,143.27 / $1,638.02	Facility		$761.87	$1,143.27	$1,638.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $817.35 / $1,103.47 / $1,158.04	Facility		$817.35	$1,103.47	$1,158.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $761.87 / $1,251.75 / $1,638.02	Facility		$761.87	$1,251.75	$1,638.02
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $219.70 / $219.70 / $219.70	Facility	80	$219.70	$219.70	$219.70
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $186.75 / $186.75 / $186.75	Facility	AS	$186.75	$186.75	$186.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,002.52 / $3,002.52 / $3,002.52	Facility		$3,002.52	$3,002.52	$3,002.52
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