Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,525.79 / $5,649.00 / $15,341.00	Facility		$1,525.79	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,114.98 / $1,600.99 / $1,802.56	Professional		$1,114.98	$1,600.99	$1,802.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $948.02 / $1,396.04 / $2,105.62	Facility		$948.02	$1,396.04	$2,105.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $915.19 / $1,320.57 / $1,420.40	Facility		$915.19	$1,320.57	$1,420.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $979.36 / $1,649.21 / $3,274.00	Facility		$979.36	$1,649.21	$3,274.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $228.35 / $228.35 / $228.35	Facility	AS	$228.35	$228.35	$228.35
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