Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,906.74 / $13,042.97 / $20,700.00	Facility		$1,906.74	$13,042.97	$20,700.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,537.46 / $2,210.09 / $2,488.34	Professional		$1,537.46	$2,210.09	$2,488.34
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,113.42 / $1,836.87 / $2,478.76	Facility		$1,113.42	$1,836.87	$2,478.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,247.05 / $1,746.02 / $1,947.69	Facility		$1,247.05	$1,746.02	$1,947.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,113.42 / $1,986.93 / $2,473.04	Facility		$1,113.42	$1,986.93	$2,473.04
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $312.23 / $312.23 / $312.23	Facility	AS	$312.23	$312.23	$312.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,325.72 / $13,016.52 / $17,767.80	Facility		$3,325.72	$13,016.52	$17,767.80
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