Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $471.28 / $4,684.68 / $8,728.00	Facility		$471.28	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $402.20 / $922.54 / $2,426.40	Professional		$402.20	$922.54	$2,426.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $282.24 / $1,017.18 / $2,907.09	Facility		$282.24	$1,017.18	$2,907.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $455.60 / $1,910.88 / $2,213.40	Facility		$455.60	$1,910.88	$2,213.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $282.24 / $1,527.09 / $2,907.09	Facility		$282.24	$1,527.09	$2,907.09
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