Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,081.30 / $2,747.00 / $7,920.26	Facility		$2,081.30	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,623.69 / $2,290.21 / $2,607.11	Professional		$1,623.69	$2,290.21	$2,607.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,380.28 / $2,132.79 / $3,110.02	Facility		$1,380.28	$2,132.79	$3,110.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,541.68 / $1,977.95 / $2,159.41	Facility		$1,541.68	$1,977.95	$2,159.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,380.28 / $2,300.23 / $2,967.60	Facility		$1,380.28	$2,300.23	$2,967.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $405.36 / $405.36 / $405.36	Facility	80	$405.36	$405.36	$405.36
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $344.55 / $344.55 / $344.55	Facility	AS	$344.55	$344.55	$344.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,710.43 / $5,710.43 / $5,710.43	Facility		$5,710.43	$5,710.43	$5,710.43
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