Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $7,920.26 / $11,425.60	Facility		$2,747.00	$7,920.26	$11,425.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7,433.56 / $10,522.33 / $11,978.28	Professional		$7,433.56	$10,522.33	$11,978.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $4,563.13 / $8,973.29 / $13,579.48	Facility		$4,563.13	$8,973.29	$13,579.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $6,653.70 / $9,055.42 / $9,562.91	Facility		$6,653.70	$9,055.42	$9,562.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $4,563.13 / $10,457.34 / $13,579.48	Facility		$4,563.13	$10,457.34	$13,579.48
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $7,151.22 / $7,151.22 / $7,151.22	Facility	62	$7,151.22	$7,151.22	$7,151.22
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $1,830.71 / $1,830.71 / $1,830.71	Facility	80	$1,830.71	$1,830.71	$1,830.71
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $1,556.11 / $1,556.11 / $1,556.11	Facility	AS	$1,556.11	$1,556.11	$1,556.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $25,118.52 / $25,118.52 / $25,118.52	Facility		$25,118.52	$25,118.52	$25,118.52
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