Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,020.71 / $13,174.72 / $26,640.02	Facility		$2,020.71	$13,174.72	$26,640.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,623.48 / $2,319.78 / $2,611.84	Professional		$1,623.48	$2,319.78	$2,611.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,172.81 / $1,954.49 / $2,775.87	Facility		$1,172.81	$1,954.49	$2,775.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,363.47 / $1,889.55 / $2,051.54	Facility		$1,363.47	$1,889.55	$2,051.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,172.81 / $2,179.35 / $2,603.48	Facility		$1,172.81	$2,179.35	$2,603.48
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $386.21 / $386.21 / $386.21	Facility	80	$386.21	$386.21	$386.21
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $328.28 / $328.28 / $328.28	Facility	AS	$328.28	$328.28	$328.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,121.29 / $5,121.29 / $5,121.29	Facility		$5,121.29	$5,121.29	$5,121.29
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