Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,144.62 / $5,380.00 / $15,341.00	Facility		$2,144.62	$5,380.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,564.89 / $2,229.76 / $2,510.48	Professional		$1,564.89	$2,229.76	$2,510.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,275.22 / $1,988.71 / $2,741.72	Facility		$1,275.22	$1,988.71	$2,741.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,368.23 / $1,843.17 / $1,956.40	Facility		$1,368.23	$1,843.17	$1,956.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,275.22 / $2,345.76 / $3,364.33	Facility		$1,275.22	$2,345.76	$3,364.33
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $368.22 / $368.22 / $368.22	Facility	80	$368.22	$368.22	$368.22
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 $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00