Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,156.86 / $5,649.00 / $15,341.00	Facility		$1,156.86	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $840.36 / $1,209.05 / $1,361.27	Professional		$840.36	$1,209.05	$1,361.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $653.35 / $1,079.72 / $1,573.78	Facility		$653.35	$1,079.72	$1,573.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $694.68 / $977.92 / $1,059.27	Facility		$694.68	$977.92	$1,059.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $731.99 / $1,244.97 / $3,274.00	Facility		$731.99	$1,244.97	$3,274.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,624.30 / $17,810.43 / $21,600.03	Facility		$13,624.30	$17,810.43	$21,600.03
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00