Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $655.88 / $4,704.00 / $8,728.00	Facility		$655.88	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $484.38 / $695.23 / $786.43	Professional		$484.38	$695.23	$786.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $389.55 / $609.62 / $837.53	Facility		$389.55	$609.62	$837.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $402.75 / $562.13 / $601.66	Facility		$402.75	$562.13	$601.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $389.55 / $712.97 / $2,724.00	Facility		$389.55	$712.97	$2,724.00
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 $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00