Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,591.62 / $9,972.00 / $20,400.00	Facility		$1,591.62	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,159.41 / $1,658.85 / $1,888.38	Professional		$1,159.41	$1,658.85	$1,888.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $742.93 / $1,225.06 / $2,057.40	Facility		$742.93	$1,225.06	$2,057.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $836.96 / $1,363.05 / $1,464.62	Facility		$836.96	$1,363.05	$1,464.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $742.93 / $1,492.33 / $2,003.00	Facility		$742.93	$1,492.33	$2,003.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $234.91 / $234.91 / $234.91	Facility	AS	$234.91	$234.91	$234.91
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
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