Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,170.21 / $7,920.26 / $20,400.00	Facility		$1,170.21	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $858.67 / $1,229.75 / $1,385.08	Professional		$858.67	$1,229.75	$1,385.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $754.58 / $1,129.55 / $1,622.35	Facility		$754.58	$1,129.55	$1,622.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $739.35 / $1,002.32 / $1,072.00	Facility		$739.35	$1,002.32	$1,072.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $754.58 / $1,274.88 / $5,626.00	Facility		$754.58	$1,274.88	$5,626.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,508.06 / $10,952.22 / $13,050.49	Facility		$8,508.06	$10,952.22	$13,050.49
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