Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,534.53 / $12,274.80 / $21,735.00	Facility		$1,534.53	$12,274.80	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,112.53 / $1,594.63 / $1,795.39	Professional		$1,112.53	$1,594.63	$1,795.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $907.13 / $1,411.78 / $1,950.33	Facility		$907.13	$1,411.78	$1,950.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $917.16 / $1,266.97 / $1,398.29	Facility		$917.16	$1,266.97	$1,398.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $907.13 / $1,511.73 / $1,804.92	Facility		$907.13	$1,511.73	$1,804.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,686.70 / $13,418.23 / $17,767.80	Facility		$5,686.70	$13,418.23	$17,767.80
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