Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,112.60 / $2,747.00 / $7,920.26	Facility		$2,112.60	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.26 / $2,339.40 / $2,663.10	Professional		$1,659.26	$2,339.40	$2,663.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,399.56 / $2,180.40 / $3,164.63	Facility		$1,399.56	$2,180.40	$3,164.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,563.00 / $2,021.27 / $2,188.23	Facility		$1,563.00	$2,021.27	$2,188.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,399.56 / $2,332.37 / $3,009.05	Facility		$1,399.56	$2,332.37	$3,009.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,783.19 / $5,783.19 / $5,783.19	Facility		$5,783.19	$5,783.19	$5,783.19
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