Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,127.50 / $9,972.00 / $20,400.00	Facility		$1,127.50	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $825.34 / $1,182.11 / $1,331.26	Professional		$825.34	$1,182.11	$1,331.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $728.19 / $1,089.68 / $1,565.61	Facility		$728.19	$1,089.68	$1,565.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $713.67 / $962.02 / $1,031.13	Facility		$713.67	$962.02	$1,031.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $728.19 / $1,230.06 / $7,952.00	Facility		$728.19	$1,230.06	$7,952.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,763.99 / $12,103.13 / $13,092.93	Facility		$8,763.99	$12,103.13	$13,092.93
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $25,015.00	Facility		$2,155.00	$12,835.00	$25,015.00