Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,050.66 / $9,972.00 / $20,400.00	Facility		$2,050.66	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.28 / $2,087.19 / $2,376.01	Professional		$1,479.28	$2,087.19	$2,376.01
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,248.40 / $1,946.88 / $2,811.05	Facility		$1,248.40	$1,946.88	$2,811.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,393.91 / $1,802.04 / $1,942.08	Facility		$1,393.91	$1,802.04	$1,942.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,248.40 / $2,080.46 / $2,684.06	Facility		$1,248.40	$2,080.46	$2,684.06
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $366.94 / $366.94 / $366.94	Facility	80	$366.94	$366.94	$366.94
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $311.89 / $311.89 / $311.89	Facility	AS	$311.89	$311.89	$311.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,155.56 / $15,446.46 / $19,829.00	Facility		$7,155.56	$15,446.46	$19,829.00
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,733.34 / $23,169.69 / $29,743.50	Facility	50	$10,733.34	$23,169.69	$29,743.50
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