Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $740.15 / $4,684.68 / $8,728.00	Facility		$740.15	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $635.78 / $791.24 / $992.10	Professional		$635.78	$791.24	$992.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $438.73 / $820.87 / $1,127.07	Facility		$438.73	$820.87	$1,127.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $505.92 / $776.07 / $830.76	Facility		$505.92	$776.07	$830.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $438.73 / $906.71 / $1,738.00	Facility		$438.73	$906.71	$1,738.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,490.06 / $27,709.28 / $34,486.44	Facility		$12,490.06	$27,709.28	$34,486.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00