Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,401.17 / $11,377.08 / $18,360.00	Facility		$2,401.17	$11,377.08	$18,360.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,916.78 / $2,728.81 / $3,072.36	Professional		$1,916.78	$2,728.81	$3,072.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,560.36 / $2,433.38 / $3,354.77	Facility		$1,560.36	$2,433.38	$3,354.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,680.38 / $2,261.71 / $2,399.27	Facility		$1,680.38	$2,261.71	$2,399.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,560.36 / $2,631.08 / $3,225.72	Facility		$1,560.36	$2,631.08	$3,225.72
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $451.99 / $451.99 / $451.99	Facility	80	$451.99	$451.99	$451.99
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $384.19 / $384.19 / $384.19	Facility	AS	$384.19	$384.19	$384.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,141.67 / $6,141.67 / $6,141.67	Facility		$6,141.67	$6,141.67	$6,141.67
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