Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $354.81 / $6,606.93	Facility		$204.17	$354.81	$6,606.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $302.00 / $398.11	Professional		$204.17	$302.00	$398.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $263.03 / $398.11	Facility		$169.82	$263.03	$398.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $302.00 / $323.59	Facility		$229.09	$302.00	$323.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $229.09 / $371.54	Facility		$165.96	$229.09	$371.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $6,918.31 / $8,709.64	Facility		$5,011.87	$6,918.31	$8,709.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $9,120.11 / $12,882.50	Facility		$1,995.26	$9,120.11	$12,882.50