Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,529.43 / $7,920.26 / $20,400.00	Facility		$1,529.43	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,114.01 / $1,579.60 / $1,798.16	Professional		$1,114.01	$1,579.60	$1,798.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $931.04 / $1,451.96 / $2,283.46	Facility		$931.04	$1,451.96	$2,283.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,038.77 / $1,357.07 / $1,579.86	Facility		$1,038.77	$1,357.07	$1,579.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $931.04 / $1,789.25 / $7,455.00	Facility		$931.04	$1,789.25	$7,455.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $230.76 / $230.76 / $230.76	Facility	AS	$230.76	$230.76	$230.76
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