Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,521.53 / $1,662.64 / $1,847.88	Facility		$1,521.53	$1,662.64	$1,847.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,204.23 / $1,692.33 / $1,926.50	Professional		$1,204.23	$1,692.33	$1,926.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,004.33 / $1,566.25 / $2,258.46	Facility		$1,004.33	$1,566.25	$2,258.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,115.32 / $1,466.96 / $1,576.51	Facility		$1,115.32	$1,466.96	$1,576.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $733.90 / $1,866.98 / $2,258.46	Facility		$733.90	$1,866.98	$2,258.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,120.49 / $4,120.49 / $4,120.49	Facility		$4,120.49	$4,120.49	$4,120.49