Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,737.80 / $7,943.28	Facility		$1,000.00	$1,737.80	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,380.38 / $1,778.28	Professional		$1,047.13	$1,380.38	$1,778.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,096.48 / $2,137.96	Facility		$707.95	$1,096.48	$2,137.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,348.96 / $1,412.54	Facility		$1,023.29	$1,348.96	$1,412.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,000.00 / $1,659.59	Facility		$707.95	$1,000.00	$1,659.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility		$3,630.78	$3,630.78	$3,630.78
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $10,232.93 / $37,153.52	Facility		$2,454.71	$10,232.93	$37,153.52