Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,778.28 / $15,848.93	Facility		$851.14	$1,778.28	$15,848.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,288.25 / $1,698.24	Professional		$977.24	$1,288.25	$1,698.24
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,174.90 / $3,630.78	Facility		$776.25	$1,174.90	$3,630.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,348.96 / $1,412.54	Facility		$1,122.02	$1,348.96	$1,412.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,000.00 / $1,659.59	Facility		$741.31	$1,000.00	$1,659.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $19,054.61 / $23,988.33 / $28,840.32	Facility		$19,054.61	$23,988.33	$28,840.32
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $17,782.79 / $32,359.37	Facility		$2,884.03	$17,782.79	$32,359.37