Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,748.34 / $2,747.00 / $7,920.26	Facility		$1,748.34	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,341.94 / $1,911.93 / $2,152.64	Professional		$1,341.94	$1,911.93	$2,152.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,235.21 / $1,849.48 / $2,655.70	Facility		$1,235.21	$1,849.48	$2,655.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,222.88 / $1,634.73 / $1,706.49	Facility		$1,222.88	$1,634.73	$1,706.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,235.21 / $1,926.31 / $2,342.69	Facility		$1,235.21	$1,926.31	$2,342.69
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $327.75 / $327.75 / $327.75	Facility	80	$327.75	$327.75	$327.75
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $278.58 / $278.58 / $278.58	Facility	AS	$278.58	$278.58	$278.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,457.60 / $4,457.60 / $4,457.60	Facility		$4,457.60	$4,457.60	$4,457.60
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00