Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,350.15 / $4,704.00 / $8,728.00	Facility		$1,350.15	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $987.23 / $1,411.52 / $1,589.22	Professional		$987.23	$1,411.52	$1,589.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $801.73 / $1,250.30 / $1,723.72	Facility		$801.73	$1,250.30	$1,723.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $855.14 / $1,152.22 / $1,230.11	Facility		$855.14	$1,152.22	$1,230.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $801.73 / $1,473.25 / $2,724.00	Facility		$801.73	$1,473.25	$2,724.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,927.24 / $22,870.85 / $34,486.44	Facility		$11,927.24	$22,870.85	$34,486.44
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