Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $687.47 / $4,684.68 / $8,728.00	Facility		$687.47	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $587.44 / $737.60 / $928.52	Professional		$587.44	$737.60	$928.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $408.27 / $762.77 / $1,107.44	Facility		$408.27	$762.77	$1,107.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $459.29 / $725.92 / $780.55	Facility		$459.29	$725.92	$780.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $408.27 / $852.48 / $1,889.20	Facility		$408.27	$852.48	$1,889.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,525.75 / $15,225.66 / $19,370.28	Facility		$11,525.75	$15,225.66	$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