Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.11 / $1,114.77 / $7,920.26	Facility		$0.11	$1,114.77	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $863.60 / $1,229.61 / $1,399.76	Professional		$863.60	$1,229.61	$1,399.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $736.85 / $1,112.28 / $1,621.65	Facility		$736.85	$1,112.28	$1,621.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $798.94 / $1,052.02 / $1,125.40	Facility		$798.94	$1,052.02	$1,125.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $736.85 / $1,227.96 / $1,621.65	Facility		$736.85	$1,227.96	$1,621.65
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $214.30 / $214.30 / $214.30	Facility	80	$214.30	$214.30	$214.30
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $182.16 / $182.16 / $182.16	Facility	AS	$182.16	$182.16	$182.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,811.13 / $10,179.44 / $11,932.41	Facility		$7,811.13	$10,179.44	$11,932.41
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00