Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $797.99 / $2,747.00 / $7,920.26	Facility		$797.99	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $624.28 / $880.16 / $1,001.94	Professional		$624.28	$880.16	$1,001.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $418.79 / $785.70 / $1,154.22	Facility		$418.79	$785.70	$1,154.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $566.35 / $760.48 / $816.68	Facility		$566.35	$760.48	$816.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $418.79 / $869.80 / $1,137.39	Facility		$418.79	$869.80	$1,137.39
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $154.56 / $154.56 / $154.56	Facility	80	$154.56	$154.56	$154.56
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $131.38 / $131.38 / $131.38	Facility	AS	$131.38	$131.38	$131.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,129.42 / $2,129.42 / $2,129.42	Facility		$2,129.42	$2,129.42	$2,129.42
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