Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,180.05 / $9,972.00 / $30,184.76	Facility		$1,180.05	$9,972.00	$30,184.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $897.76 / $1,288.26 / $1,450.45	Professional		$897.76	$1,288.26	$1,450.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $664.54 / $1,107.46 / $1,512.43	Facility		$664.54	$1,107.46	$1,512.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $755.82 / $1,041.17 / $1,153.74	Facility		$755.82	$1,041.17	$1,153.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $664.54 / $1,315.44 / $7,952.00	Facility		$664.54	$1,315.44	$7,952.00
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 $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00