Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $720.96 / $4,704.00 / $8,728.00	Facility		$720.96	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $519.50 / $731.75 / $833.00	Professional		$519.50	$731.75	$833.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $317.33 / $629.49 / $946.43	Facility		$317.33	$629.49	$946.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $460.56 / $632.85 / $692.11	Facility		$460.56	$632.85	$692.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $317.33 / $733.59 / $946.43	Facility		$317.33	$733.59	$946.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,752.42 / $9,645.90 / $11,932.41	Facility		$7,752.42	$9,645.90	$11,932.41
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00