Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,539.81 / $2,747.00 / $7,920.26	Facility		$1,539.81	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.76 / $1,755.88 / $1,976.95	Professional		$1,230.76	$1,755.88	$1,976.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $781.93 / $1,540.90 / $2,202.00	Facility		$781.93	$1,540.90	$2,202.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,104.66 / $1,499.28 / $1,572.49	Facility		$1,104.66	$1,499.28	$1,572.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $781.93 / $1,681.15 / $1,998.51	Facility		$781.93	$1,681.15	$1,998.51
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $253.69 / $253.69 / $253.69	Facility	AS	$253.69	$253.69	$253.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,058.33 / $4,058.33 / $4,058.33	Facility		$4,058.33	$4,058.33	$4,058.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00