Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,116.62 / $7,920.26 / $29,270.82	Facility		$5,116.62	$7,920.26	$29,270.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,797.51 / $6,782.45 / $7,720.93	Professional		$4,797.51	$6,782.45	$7,720.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $4,063.07 / $6,038.01 / $8,809.86	Facility		$4,063.07	$6,038.01	$8,809.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,358.49 / $5,844.23 / $6,176.06	Facility		$4,358.49	$5,844.23	$6,176.06
Providence Facility/Professional Facility Modifier Low / Median / High Price $4,063.07 / $6,680.58 / $8,735.60	Facility		$4,063.07	$6,680.58	$8,735.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $1,184.71 / $1,184.71 / $1,184.71	Facility	80	$1,184.71	$1,184.71	$1,184.71
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $1,007.01 / $1,007.01 / $1,007.01	Facility	AS	$1,007.01	$1,007.01	$1,007.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $16,284.88 / $16,284.88 / $16,284.88	Facility		$16,284.88	$16,284.88	$16,284.88
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