Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $4,073.80 / $15,848.93	Facility		$3,162.28	$4,073.80	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $3,162.28 / $4,168.69	Professional		$2,454.71	$3,162.28	$4,168.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,884.03 / $5,623.41	Facility		$1,949.84	$2,884.03	$5,623.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,090.30 / $3,235.94	Facility		$2,344.23	$3,090.30	$3,235.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,238.72 / $3,890.45	Facility		$1,819.70	$2,238.72	$3,890.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,317.64 / $8,317.64 / $8,317.64	Facility		$8,317.64	$8,317.64	$8,317.64
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $10,232.93 / $37,153.52	Facility		$2,454.71	$10,232.93	$37,153.52