Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,570.40 / $7,943.28	Facility		$1,412.54	$2,570.40	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $2,187.76 / $2,630.27	Professional		$977.24	$2,187.76	$2,630.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,995.26 / $3,019.95	Facility		$1,412.54	$1,995.26	$3,019.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,995.26 / $2,187.76	Facility		$1,698.24	$1,995.26	$2,187.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,819.70 / $2,691.53	Facility		$1,202.26	$1,819.70	$2,691.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $5,754.40 / $5,754.40	Facility		$5,754.40	$5,754.40	$5,754.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $10,232.93 / $37,153.52	Facility		$2,454.71	$10,232.93	$37,153.52