Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,266.51 / $2,747.00 / $7,920.26	Facility		$1,266.51	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $989.09 / $1,394.31 / $1,587.24	Professional		$989.09	$1,394.31	$1,587.24
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $811.78 / $1,244.83 / $1,833.61	Facility		$811.78	$1,244.83	$1,833.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $916.27 / $1,204.88 / $1,283.05	Facility		$916.27	$1,204.88	$1,283.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $811.78 / $1,388.87 / $1,805.18	Facility		$811.78	$1,388.87	$1,805.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $245.52 / $245.52 / $245.52	Facility	80	$245.52	$245.52	$245.52
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $208.70 / $208.70 / $208.70	Facility	AS	$208.70	$208.70	$208.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,376.96 / $3,376.96 / $3,376.96	Facility		$3,376.96	$3,376.96	$3,376.96
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