Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,676.91 / $8,878.56 / $20,400.00	Facility		$1,676.91	$8,878.56	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,209.18 / $1,714.61 / $1,951.86	Professional		$1,209.18	$1,714.61	$1,951.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $957.57 / $1,521.84 / $2,254.76	Facility		$957.57	$1,521.84	$2,254.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,042.10 / $1,472.99 / $1,587.12	Facility		$1,042.10	$1,472.99	$1,587.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,028.16 / $1,945.62 / $8,061.00	Facility		$1,028.16	$1,945.62	$8,061.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $254.89 / $254.89 / $254.89	Facility	AS	$254.89	$254.89	$254.89
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