Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,119.98 / $2,747.00 / $7,920.26	Facility		$2,119.98	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,656.86 / $2,336.82 / $2,660.16	Professional		$1,656.86	$2,336.82	$2,660.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,405.65 / $2,184.54 / $3,173.88	Facility		$1,405.65	$2,184.54	$3,173.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,570.75 / $2,018.35 / $2,187.56	Facility		$1,570.75	$2,018.35	$2,187.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,405.65 / $2,342.52 / $3,022.15	Facility		$1,405.65	$2,342.52	$3,022.15
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $413.32 / $413.32 / $413.32	Facility	80	$413.32	$413.32	$413.32
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $351.32 / $351.32 / $351.32	Facility	AS	$351.32	$351.32	$351.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,813.37 / $5,813.37 / $5,813.37	Facility		$5,813.37	$5,813.37	$5,813.37
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