Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,048.27 / $2,747.00 / $7,920.26	Facility		$1,048.27	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $820.45 / $1,179.72 / $1,342.96	Professional		$820.45	$1,179.72	$1,342.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $621.57 / $1,013.13 / $1,523.23	Facility		$621.57	$1,013.13	$1,523.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $678.42 / $986.24 / $1,053.24	Facility		$678.42	$986.24	$1,053.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $621.57 / $1,104.86 / $1,523.23	Facility		$621.57	$1,104.86	$1,523.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,597.50 / $9,123.83 / $12,623.94	Facility		$4,597.50	$9,123.83	$12,623.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00