Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,649.00 / $2,747.00 / $7,920.26	Facility		$1,649.00	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,315.04 / $1,875.86 / $2,135.42	Professional		$1,315.04	$1,875.86	$2,135.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,105.29 / $1,658.89 / $2,376.37	Facility		$1,105.29	$1,658.89	$2,376.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,186.06 / $1,601.96 / $1,679.02	Facility		$1,186.06	$1,601.96	$1,679.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,105.29 / $1,816.31 / $2,376.37	Facility		$1,105.29	$1,816.31	$2,376.37
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $319.39 / $319.39 / $319.39	Facility	80	$319.39	$319.39	$319.39
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $271.49 / $271.49 / $271.49	Facility	AS	$271.49	$271.49	$271.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,352.93 / $4,352.93 / $4,352.93	Facility		$4,352.93	$4,352.93	$4,352.93
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