Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $4,742.89 / $7,920.26	Facility		$2,747.00	$4,742.89	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,090.81 / $4,378.02 / $4,983.80	Professional		$3,090.81	$4,378.02	$4,983.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,898.58 / $3,879.92 / $5,623.95	Facility		$1,898.58	$3,879.92	$5,623.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,456.58 / $3,765.16 / $3,967.07	Facility		$2,456.58	$3,765.16	$3,967.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,898.58 / $4,197.05 / $5,593.25	Facility		$1,898.58	$4,197.05	$5,593.25
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $758.55 / $758.55 / $758.55	Facility	80	$758.55	$758.55	$758.55
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $644.76 / $644.76 / $644.76	Facility	AS	$644.76	$644.76	$644.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,402.32 / $10,402.32 / $10,402.32	Facility		$10,402.32	$10,402.32	$10,402.32
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