Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $682.83 / $4,684.68 / $8,728.00	Facility		$682.83	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $585.03 / $738.83 / $930.65	Professional		$585.03	$738.83	$930.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $405.06 / $752.81 / $1,085.47	Facility		$405.06	$752.81	$1,085.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $510.27 / $726.77 / $776.53	Facility		$510.27	$726.77	$776.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $405.06 / $842.57 / $1,738.00	Facility		$405.06	$842.57	$1,738.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,927.24 / $16,067.82 / $19,370.28	Facility		$11,927.24	$16,067.82	$19,370.28
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