Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,457.01 / $7,920.26 / $20,400.00	Facility		$1,457.01	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,052.00 / $1,491.30 / $1,697.65	Professional		$1,052.00	$1,491.30	$1,697.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $891.42 / $1,327.94 / $1,916.55	Facility		$891.42	$1,327.94	$1,916.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $984.50 / $1,281.53 / $1,377.68	Facility		$984.50	$1,281.53	$1,377.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $891.42 / $1,698.30 / $7,455.00	Facility		$891.42	$1,698.30	$7,455.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $221.26 / $221.26 / $221.26	Facility	AS	$221.26	$221.26	$221.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,954.82 / $16,642.54 / $20,571.93	Facility		$12,954.82	$16,642.54	$20,571.93
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