Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,982.88 / $9,972.00 / $20,400.00	Facility		$1,982.88	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,425.70 / $2,020.28 / $2,299.83	Professional		$1,425.70	$2,020.28	$2,299.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,222.78 / $1,817.46 / $2,663.88	Facility		$1,222.78	$1,817.46	$2,663.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,259.47 / $1,736.76 / $1,882.24	Facility		$1,259.47	$1,736.76	$1,882.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,222.78 / $2,037.76 / $2,663.88	Facility		$1,222.78	$2,037.76	$2,663.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,954.82 / $16,642.54 / $20,571.93	Facility		$12,954.82	$16,642.54	$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