Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,552.73 / $3,117.20 / $7,920.26	Facility		$2,552.73	$3,117.20	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,032.48 / $2,888.43 / $3,252.08	Professional		$2,032.48	$2,888.43	$3,252.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,656.30 / $2,583.00 / $3,561.05	Facility		$1,656.30	$2,583.00	$3,561.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,795.56 / $2,411.06 / $2,547.34	Facility		$1,795.56	$2,411.06	$2,547.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,656.30 / $2,809.54 / $3,435.83	Facility		$1,656.30	$2,809.54	$3,435.83
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,877.01 / $1,877.01 / $1,877.01	Facility	62	$1,877.01	$1,877.01	$1,877.01
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $480.52 / $480.52 / $480.52	Facility	80	$480.52	$480.52	$480.52
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $408.44 / $408.44 / $408.44	Facility	AS	$408.44	$408.44	$408.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,540.94 / $6,540.94 / $6,540.94	Facility		$6,540.94	$6,540.94	$6,540.94
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