Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,114.54 / $12,274.80 / $21,735.00	Facility		$2,114.54	$12,274.80	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,531.19 / $2,185.62 / $2,460.79	Professional		$1,531.19	$2,185.62	$2,460.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,112.84 / $1,854.56 / $2,662.95	Facility		$1,112.84	$1,854.56	$2,662.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,328.98 / $1,799.29 / $1,940.32	Facility		$1,328.98	$1,799.29	$1,940.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,112.84 / $2,066.98 / $2,465.32	Facility		$1,112.84	$2,066.98	$2,465.32
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $366.30 / $366.30 / $366.30	Facility	80	$366.30	$366.30	$366.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,856.88 / $4,856.88 / $4,856.88	Facility		$4,856.88	$4,856.88	$4,856.88
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