Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,339.26 / $5,649.00 / $15,341.00	Facility		$1,339.26	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $979.09 / $1,399.75 / $1,575.98	Professional		$979.09	$1,399.75	$1,575.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $795.55 / $1,240.66 / $1,710.43	Facility		$795.55	$1,240.66	$1,710.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $847.39 / $1,141.21 / $1,226.09	Facility		$847.39	$1,141.21	$1,226.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $795.55 / $1,459.14 / $3,274.00	Facility		$795.55	$1,459.14	$3,274.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,525.75 / $15,225.66 / $19,370.28	Facility		$11,525.75	$15,225.66	$19,370.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00