Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,761.68 / $5,878.95 / $20,400.00	Facility		$4,761.68	$5,878.95	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,838.84 / $5,486.83 / $6,177.62	Professional		$3,838.84	$5,486.83	$6,177.62
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $3,008.38 / $4,832.78 / $7,020.68	Facility		$3,008.38	$4,832.78	$7,020.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,388.46 / $4,529.22 / $4,898.37	Facility		$3,388.46	$4,529.22	$4,898.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,098.93 / $5,235.22 / $6,662.70	Facility		$3,098.93	$5,235.22	$6,662.70
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $3,624.04 / $3,624.04 / $3,624.04	Facility	62	$3,624.04	$3,624.04	$3,624.04
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $927.75 / $927.75 / $927.75	Facility	80	$927.75	$927.75	$927.75
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $788.59 / $788.59 / $788.59	Facility	AS	$788.59	$788.59	$788.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,439.47 / $12,439.47 / $12,439.47	Facility		$12,439.47	$12,439.47	$12,439.47
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