Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $805.72 / $5,318.00 / $13,089.16	Facility		$805.72	$5,318.00	$13,089.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $657.52 / $942.40 / $1,062.88	Professional		$657.52	$942.40	$1,062.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $529.36 / $862.79 / $1,138.11	Facility		$529.36	$862.79	$1,138.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $559.60 / $773.85 / $830.54	Facility		$559.60	$773.85	$830.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $529.36 / $967.98 / $3,274.00	Facility		$529.36	$967.98	$3,274.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,927.24 / $16,067.82 / $19,370.28	Facility		$11,927.24	$16,067.82	$19,370.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00