Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,089.44 / $9,338.46 / $20,400.00	Facility		$2,089.44	$9,338.46	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,501.23 / $2,127.03 / $2,421.34	Professional		$1,501.23	$2,127.03	$2,421.34
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,286.90 / $1,889.41 / $2,986.91	Facility		$1,286.90	$1,889.41	$2,986.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,409.41 / $1,828.77 / $2,089.44	Facility		$1,409.41	$1,828.77	$2,089.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,286.90 / $2,340.75 / $2,986.91	Facility		$1,286.90	$2,340.75	$2,986.91
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $374.52 / $374.52 / $374.52	Facility	80	$374.52	$374.52	$374.52
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $318.33 / $318.33 / $318.33	Facility	AS	$318.33	$318.33	$318.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,220.66 / $5,220.66 / $5,220.66	Facility		$5,220.66	$5,220.66	$5,220.66
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00