Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.52 / $4,704.00 / $8,728.00	Facility		$128.52	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.48 / $131.88 / $150.12	Professional		$93.48	$131.88	$150.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $117.30 / $165.74	Facility		$77.09	$117.30	$165.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $81.88 / $112.56 / $118.59	Facility		$81.88	$112.56	$118.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $125.81 / $165.74	Facility		$77.09	$125.81	$165.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $861.54 / $1,116.86 / $1,502.14	Facility		$861.54	$1,116.86	$1,502.14
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00