Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.69 / $5,045.30 / $7,920.26	Facility		$143.69	$5,045.30	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,653.74 / $5,177.95 / $5,894.42	Professional		$3,653.74	$5,177.95	$5,894.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $3,083.44 / $4,598.50 / $6,672.65	Facility		$3,083.44	$4,598.50	$6,672.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,349.35 / $4,450.92 / $4,727.35	Facility		$3,349.35	$4,450.92	$4,727.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,083.44 / $5,079.00 / $6,629.40	Facility		$3,083.44	$5,079.00	$6,629.40
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $897.43 / $897.43 / $897.43	Facility	80	$897.43	$897.43	$897.43
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $762.82 / $762.82 / $762.82	Facility	AS	$762.82	$762.82	$762.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,301.04 / $12,301.04 / $12,301.04	Facility		$12,301.04	$12,301.04	$12,301.04
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