Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,097.65 / $8,878.56 / $20,400.00	Facility		$1,097.65	$8,878.56	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $789.60 / $1,133.59 / $1,276.32	Professional		$789.60	$1,133.59	$1,276.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $654.38 / $1,020.51 / $1,406.92	Facility		$654.38	$1,020.51	$1,406.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.80 / $921.59 / $1,003.66	Facility		$676.80	$921.59	$1,003.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $654.38 / $1,173.61 / $3,290.00	Facility		$654.38	$1,173.61	$3,290.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,993.29 / $6,338.31 / $7,624.85	Facility		$4,993.29	$6,338.31	$7,624.85
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00