Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $292.77 / $2,747.00 / $7,920.26	Facility		$292.77	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $228.27 / $320.27 / $364.59	Professional		$228.27	$320.27	$364.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $193.08 / $301.11 / $436.88	Facility		$193.08	$301.11	$436.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $217.06 / $278.08 / $304.18	Facility		$217.06	$278.08	$304.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $193.08 / $321.77 / $415.12	Facility		$193.08	$321.77	$415.12
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $57.04 / $57.04 / $57.04	Facility	80	$57.04	$57.04	$57.04
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $48.49 / $48.49 / $48.49	Facility	AS	$48.49	$48.49	$48.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $803.85 / $803.85 / $803.85	Facility		$803.85	$803.85	$803.85
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