Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,745.07 / $7,920.26 / $20,400.00	Facility		$1,745.07	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,269.42 / $1,801.31 / $2,050.56	Professional		$1,269.42	$1,801.31	$2,050.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $781.16 / $1,520.82 / $2,286.55	Facility		$781.16	$1,520.82	$2,286.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,136.03 / $1,546.38 / $1,628.10	Facility		$1,136.03	$1,546.38	$1,628.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $781.16 / $1,658.54 / $2,286.55	Facility		$781.16	$1,658.54	$2,286.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,269.52 / $4,269.52 / $4,269.52	Facility		$4,269.52	$4,269.52	$4,269.52
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