Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,682.50 / $2,747.00 / $7,920.26	Facility		$1,682.50	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,338.06 / $1,912.11 / $2,152.85	Professional		$1,338.06	$1,912.11	$2,152.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $856.11 / $1,597.62 / $2,336.21	Facility		$856.11	$1,597.62	$2,336.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,189.93 / $1,602.75 / $1,711.85	Facility		$1,189.93	$1,602.75	$1,711.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $856.11 / $1,839.33 / $2,168.42	Facility		$856.11	$1,839.33	$2,168.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,363.59 / $4,363.59 / $4,363.59	Facility		$4,363.59	$4,363.59	$4,363.59
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