Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,663.16 / $4,704.00 / $8,728.00	Facility		$1,663.16	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,217.36 / $1,740.76 / $1,959.92	Professional		$1,217.36	$1,740.76	$1,959.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $987.69 / $1,660.65 / $2,123.53	Facility		$987.69	$1,660.65	$2,123.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,053.30 / $1,456.58 / $1,638.80	Facility		$1,053.30	$1,456.58	$1,638.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $987.69 / $1,836.27 / $2,724.00	Facility		$987.69	$1,836.27	$2,724.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $284.45 / $284.45 / $284.45	Facility	80	$284.45	$284.45	$284.45
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $241.79 / $241.79 / $241.79	Facility	AS	$241.79	$241.79	$241.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $49,533.96 / $65,887.53 / $75,513.42	Facility		$49,533.96	$65,887.53	$75,513.42
United Facility/Professional Facility Modifier Low / Median / High Price $3,960.00 / $30,636.00 / $55,640.00	Facility		$3,960.00	$30,636.00	$55,640.00