Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $743.92 / $5,633.00 / $20,400.00	Facility		$743.92	$5,633.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $632.79 / $1,223.23 / $3,207.10	Professional		$632.79	$1,223.23	$3,207.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $444.13 / $1,223.23 / $3,559.80	Facility		$444.13	$1,223.23	$3,559.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $665.31 / $2,363.42 / $2,810.44	Facility		$665.31	$2,363.42	$2,810.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $444.13 / $1,978.59 / $3,559.80	Facility		$444.13	$1,978.59	$3,559.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,508.06 / $10,952.22 / $13,050.49	Facility		$8,508.06	$10,952.22	$13,050.49
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $12,762.09 / $16,428.33 / $19,575.74	Facility	50	$12,762.09	$16,428.33	$19,575.74
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00