Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,133.14 / $9,972.00 / $20,400.00	Facility		$2,133.14	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,538.86 / $2,196.76 / $2,473.33	Professional		$1,538.86	$2,196.76	$2,473.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,122.99 / $1,871.46 / $2,636.11	Facility		$1,122.99	$1,871.46	$2,636.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,316.39 / $1,792.17 / $1,945.68	Facility		$1,316.39	$1,792.17	$1,945.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,122.99 / $2,082.92 / $2,479.91	Facility		$1,122.99	$2,082.92	$2,479.91
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $369.12 / $369.12 / $369.12	Facility	80	$369.12	$369.12	$369.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,803.64 / $4,803.64 / $4,803.64	Facility		$4,803.64	$4,803.64	$4,803.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,529.00 / $12,113.00	Facility		$1,981.00	$9,529.00	$12,113.00