Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $5,116.62 / $7,920.26	Facility		$2,747.00	$5,116.62	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,466.87 / $4,921.99 / $5,541.67	Professional		$3,466.87	$4,921.99	$5,541.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,829.02 / $4,411.85 / $6,082.39	Facility		$2,829.02	$4,411.85	$6,082.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,042.43 / $4,125.18 / $4,336.91	Facility		$3,042.43	$4,125.18	$4,336.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,829.02 / $4,811.72 / $5,872.93	Facility		$2,829.02	$4,811.72	$5,872.93
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $3,196.94 / $3,196.94 / $3,196.94	Facility	62	$3,196.94	$3,196.94	$3,196.94
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $818.42 / $818.42 / $818.42	Facility	80	$818.42	$818.42	$818.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $695.65 / $695.65 / $695.65	Facility	AS	$695.65	$695.65	$695.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,172.46 / $11,172.46 / $11,172.46	Facility		$11,172.46	$11,172.46	$11,172.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00