Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,398.83 / $7,943.28	Facility		$1,288.25	$2,398.83	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,995.26 / $2,454.71	Professional		$891.25	$1,995.26	$2,454.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,862.09 / $2,754.23	Facility		$1,288.25	$1,862.09	$2,754.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,862.09 / $1,995.26	Facility		$1,479.11	$1,862.09	$1,995.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,659.59 / $2,511.89	Facility		$1,122.02	$1,659.59	$2,511.89
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