Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $7,943.28 / $13,803.84	Facility		$1,288.25	$7,943.28	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,348.96 / $1,659.59	Professional		$602.56	$1,348.96	$1,659.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,288.25 / $11,481.54	Facility		$851.14	$1,288.25	$11,481.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,230.27 / $1,318.26	Facility		$1,071.52	$1,230.27	$1,318.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,122.02 / $1,659.59	Facility		$758.58	$1,122.02	$1,659.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $17,378.01 / $21,379.62	Facility		$12,882.50	$17,378.01	$21,379.62
United Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $20,892.96 / $26,302.68	Facility		$3,019.95	$20,892.96	$26,302.68