Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,260.92 / $7,920.26 / $20,400.00	Facility		$1,260.92	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $910.87 / $1,289.48 / $1,467.91	Professional		$910.87	$1,289.48	$1,467.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $768.04 / $1,179.21 / $1,728.10	Facility		$768.04	$1,179.21	$1,728.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $850.30 / $1,109.59 / $1,192.72	Facility		$850.30	$1,109.59	$1,192.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $768.04 / $1,279.94 / $1,728.10	Facility		$768.04	$1,279.94	$1,728.10
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $191.55 / $191.55 / $191.55	Facility	AS	$191.55	$191.55	$191.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,954.82 / $17,563.07 / $20,571.93	Facility		$12,954.82	$17,563.07	$20,571.93
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00