Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,205.67 / $6,900.50 / $19,370.78	Facility		$1,205.67	$6,900.50	$19,370.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $983.90 / $1,409.46 / $1,586.91	Professional		$983.90	$1,409.46	$1,586.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $611.23 / $1,238.31 / $1,876.19	Facility		$611.23	$1,238.31	$1,876.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $850.23 / $1,179.20 / $1,312.53	Facility		$850.23	$1,179.20	$1,312.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $716.13 / $1,539.68 / $7,952.00	Facility		$716.13	$1,539.68	$7,952.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $236.02 / $236.02 / $236.02	Facility	80	$236.02	$236.02	$236.02
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $200.61 / $200.61 / $200.61	Facility	AS	$200.61	$200.61	$200.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,039.76 / $15,838.63 / $18,619.91	Facility		$12,039.76	$15,838.63	$18,619.91
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