Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,745.14 / $7,920.26 / $76,292.28	Facility		$4,745.14	$7,920.26	$76,292.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,738.62 / $5,294.45 / $6,027.03	Professional		$3,738.62	$5,294.45	$6,027.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $3,158.88 / $4,714.77 / $6,847.59	Facility		$3,158.88	$4,714.77	$6,847.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,439.47 / $4,554.31 / $4,801.22	Facility		$3,439.47	$4,554.31	$4,801.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,158.88 / $5,226.41 / $6,791.59	Facility		$3,158.88	$5,226.41	$6,791.59
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $3,587.91 / $3,587.91 / $3,587.91	Facility	62	$3,587.91	$3,587.91	$3,587.91
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $918.50 / $918.50 / $918.50	Facility	80	$918.50	$918.50	$918.50
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $780.73 / $780.73 / $780.73	Facility	AS	$780.73	$780.73	$780.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,624.04 / $12,624.04 / $12,624.04	Facility		$12,624.04	$12,624.04	$12,624.04
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