Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,113.81 / $6,845.00 / $16,727.48	Facility		$1,113.81	$6,845.00	$16,727.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,241.18 / $1,773.57 / $1,996.86	Professional		$1,241.18	$1,773.57	$1,996.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $833.64 / $1,562.11 / $2,310.30	Facility		$833.64	$1,562.11	$2,310.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,065.15 / $1,502.81 / $1,618.05	Facility		$1,065.15	$1,502.81	$1,618.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $905.54 / $1,946.91 / $7,952.00	Facility		$905.54	$1,946.91	$7,952.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $297.95 / $297.95 / $297.95	Facility	80	$297.95	$297.95	$297.95
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $253.25 / $253.25 / $253.25	Facility	AS	$253.25	$253.25	$253.25
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