Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,263.13 / $2,747.00 / $7,920.26	Facility		$2,263.13	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,777.91 / $2,508.34 / $2,855.41	Professional		$1,777.91	$2,508.34	$2,855.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,500.42 / $2,321.16 / $3,373.81	Facility		$1,500.42	$2,321.16	$3,373.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,667.65 / $2,165.81 / $2,335.12	Facility		$1,667.65	$2,165.81	$2,335.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,500.42 / $2,500.44 / $3,225.90	Facility		$1,500.42	$2,500.44	$3,225.90
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $441.20 / $441.20 / $441.20	Facility	80	$441.20	$441.20	$441.20
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $375.02 / $375.02 / $375.02	Facility	AS	$375.02	$375.02	$375.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,175.38 / $6,175.38 / $6,175.38	Facility		$6,175.38	$6,175.38	$6,175.38
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