Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,184.19 / $2,747.00 / $7,920.26	Facility		$2,184.19	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,712.41 / $2,418.73 / $2,753.40	Professional		$1,712.41	$2,418.73	$2,753.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $2,112.67 / $3,117.50	Facility		$1,450.00	$2,112.67	$3,117.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,608.06 / $2,086.02 / $2,242.64	Facility		$1,608.06	$2,086.02	$2,242.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $2,287.46 / $3,005.42	Facility		$1,450.00	$2,287.46	$3,005.42
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $425.91 / $425.91 / $425.91	Facility	80	$425.91	$425.91	$425.91
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $362.03 / $362.03 / $362.03	Facility	AS	$362.03	$362.03	$362.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,944.66 / $5,944.66 / $5,944.66	Facility		$5,944.66	$5,944.66	$5,944.66
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