Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,456.49 / $6,656.84 / $20,400.00	Facility		$1,456.49	$6,656.84	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,188.58 / $1,708.16 / $1,926.87	Professional		$1,188.58	$1,708.16	$1,926.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $864.08 / $1,439.99 / $1,857.77	Facility		$864.08	$1,439.99	$1,857.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $919.80 / $1,302.48 / $1,501.47	Facility		$919.80	$1,302.48	$1,501.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $864.08 / $1,605.15 / $1,910.99	Facility		$864.08	$1,605.15	$1,910.99
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $241.79 / $241.79 / $241.79	Facility	AS	$241.79	$241.79	$241.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,041.14 / $9,224.37 / $11,703.59	Facility		$7,041.14	$9,224.37	$11,703.59
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