Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,238.72 / $7,943.28	Facility		$1,202.26	$2,238.72	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,905.46 / $2,344.23	Professional		$851.14	$1,905.46	$2,344.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,737.80 / $2,630.27	Facility		$1,202.26	$1,737.80	$2,630.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,737.80 / $1,862.09	Facility		$1,412.54	$1,737.80	$1,862.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,548.82 / $2,398.83	Facility		$1,071.52	$1,548.82	$2,398.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $17,378.01 / $21,379.62	Facility		$12,882.50	$17,378.01	$21,379.62
United Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $20,892.96 / $26,302.68	Facility		$3,019.95	$20,892.96	$26,302.68