Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $5,180.85 / $7,920.26	Facility		$2,747.00	$5,180.85	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,749.77 / $5,311.51 / $6,046.46	Professional		$3,749.77	$5,311.51	$6,046.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $3,169.34 / $4,719.35 / $6,861.47	Facility		$3,169.34	$4,719.35	$6,861.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,450.61 / $4,567.91 / $4,815.29	Facility		$3,450.61	$4,567.91	$4,815.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,169.34 / $5,246.06 / $6,814.08	Facility		$3,169.34	$5,246.06	$6,814.08
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $784.00 / $784.00 / $784.00	Facility	AS	$784.00	$784.00	$784.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,661.31 / $12,661.31 / $12,661.31	Facility		$12,661.31	$12,661.31	$12,661.31
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