Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,659.59 / $7,943.28	Facility		$1,288.25	$1,659.59	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,230.27 / $1,621.81	Professional		$933.25	$1,230.27	$1,621.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,238.72	Facility		$776.25	$1,122.02	$2,238.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,230.27 / $1,288.25	Facility		$977.24	$1,230.27	$1,288.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $933.25 / $1,548.82	Facility		$724.44	$933.25	$1,548.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,022.64 / $16,218.10 / $19,498.45	Facility		$12,022.64	$16,218.10	$19,498.45
United Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $20,892.96 / $26,302.68	Facility		$3,019.95	$20,892.96	$26,302.68