Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $7,943.28 / $29,512.09	Facility		$1,621.81	$7,943.28	$29,512.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,698.24 / $2,089.30	Professional		$776.25	$1,698.24	$2,089.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,380.38 / $10,232.93	Facility		$776.25	$1,380.38	$10,232.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,584.89 / $1,659.59	Facility		$977.24	$1,584.89	$1,659.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,041.74	Facility		$776.25	$1,122.02	$2,041.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,762.47 / $10,232.93 / $12,302.69	Facility		$7,762.47	$10,232.93	$12,302.69
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $12,882.50 / $26,302.68	Facility		$2,137.96	$12,882.50	$26,302.68