Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,044.04 / $7,920.26 / $20,400.00	Facility		$1,044.04	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $762.57 / $1,085.96 / $1,222.68	Professional		$762.57	$1,085.96	$1,222.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $619.48 / $1,025.39 / $1,331.88	Facility		$619.48	$1,025.39	$1,331.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $669.58 / $918.96 / $953.41	Facility		$669.58	$918.96	$953.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $619.48 / $1,150.38 / $5,626.00	Facility		$619.48	$1,150.38	$5,626.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,909.34 / $10,952.22 / $13,050.49	Facility		$6,909.34	$10,952.22	$13,050.49
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