Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $836.90 / $12,054.00 / $32,689.00	Facility		$836.90	$12,054.00	$32,689.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $607.57 / $789.50 / $948.80	Professional		$607.57	$789.50	$948.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $381.47 / $634.41 / $968.92	Facility		$381.47	$634.41	$968.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $554.19 / $740.13 / $782.00	Facility		$554.19	$740.13	$782.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $387.07 / $675.51 / $993.68	Facility		$387.07	$675.51	$993.68
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $148.65 / $148.65 / $148.65	Facility	80	$148.65	$148.65	$148.65
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $126.35 / $126.35 / $126.35	Facility	AS	$126.35	$126.35	$126.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,860.57 / $18,659.50 / $20,822.68	Facility		$15,860.57	$18,659.50	$20,822.68
United Facility/Professional Facility Modifier Low / Median / High Price $4,874.00 / $17,192.00 / $24,231.00	Facility		$4,874.00	$17,192.00	$24,231.00