Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,541.00 / $7,920.26 / $30,593.00	Facility		$1,541.00	$7,920.26	$30,593.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,111.07 / $1,573.28 / $1,790.97	Professional		$1,111.07	$1,573.28	$1,790.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $942.39 / $1,469.66 / $2,090.92	Facility		$942.39	$1,469.66	$2,090.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,039.74 / $1,353.49 / $1,460.64	Facility		$1,039.74	$1,353.49	$1,460.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $942.39 / $1,792.65 / $7,455.00	Facility		$942.39	$1,792.65	$7,455.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $234.58 / $234.58 / $234.58	Facility	AS	$234.58	$234.58	$234.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,954.82 / $17,563.07 / $20,571.93	Facility		$12,954.82	$17,563.07	$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