Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,237.22 / $5,649.00 / $15,341.00	Facility		$1,237.22	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $912.32 / $1,314.27 / $1,479.74	Professional		$912.32	$1,314.27	$1,479.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $785.24 / $1,119.10 / $1,713.57	Facility		$785.24	$1,119.10	$1,713.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $717.30 / $1,052.36 / $1,143.69	Facility		$717.30	$1,052.36	$1,143.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $797.01 / $1,328.22 / $3,274.00	Facility		$797.01	$1,328.22	$3,274.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,539.09 / $11,131.60 / $14,269.30	Facility		$8,539.09	$11,131.60	$14,269.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00