Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,371.79 / $5,649.00 / $15,341.00	Facility		$1,371.79	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,004.31 / $1,434.51 / $1,615.11	Professional		$1,004.31	$1,434.51	$1,615.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $887.70 / $1,332.55 / $1,908.56	Facility		$887.70	$1,332.55	$1,908.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $875.49 / $1,173.01 / $1,252.90	Facility		$875.49	$1,173.01	$1,252.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $887.70 / $1,506.45 / $3,274.00	Facility		$887.70	$1,506.45	$3,274.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,508.06 / $11,474.33 / $13,050.49	Facility		$8,508.06	$11,474.33	$13,050.49
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00