Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,396.00 / $4,962.67 / $15,341.00	Facility		$1,396.00	$4,962.67	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,552.77 / $2,212.78 / $2,491.37	Professional		$1,552.77	$2,212.78	$2,491.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,264.08 / $1,971.33 / $2,717.77	Facility		$1,264.08	$1,971.33	$2,717.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,352.72 / $1,813.48 / $1,948.36	Facility		$1,352.72	$1,813.48	$1,948.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,264.08 / $2,324.00 / $3,350.50	Facility		$1,264.08	$2,324.00	$3,350.50
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 / $25,015.00	Facility		$2,155.00	$12,835.00	$25,015.00