Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $548.84 / $4,684.68 / $8,728.00	Facility		$548.84	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $465.28 / $912.15 / $2,389.90	Professional		$465.28	$912.15	$2,389.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $328.50 / $1,001.88 / $2,995.38	Facility		$328.50	$1,001.88	$2,995.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $562.13 / $1,889.36 / $2,252.54	Facility		$562.13	$1,889.36	$2,252.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $328.50 / $1,523.49 / $2,995.38	Facility		$328.50	$1,523.49	$2,995.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,993.29 / $6,338.31 / $7,624.85	Facility		$4,993.29	$6,338.31	$7,624.85
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00