Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,637.87 / $7,187.00 / $23,372.58	Facility		$1,637.87	$7,187.00	$23,372.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,336.60 / $1,910.78 / $2,151.34	Professional		$1,336.60	$1,910.78	$2,151.34
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $976.41 / $1,627.19 / $2,300.12	Facility		$976.41	$1,627.19	$2,300.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,136.64 / $1,560.00 / $1,695.77	Facility		$1,136.64	$1,560.00	$1,695.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $976.41 / $1,838.43 / $2,162.41	Facility		$976.41	$1,838.43	$2,162.41
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $321.20 / $321.20 / $321.20	Facility	80	$321.20	$321.20	$321.20
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $273.02 / $273.02 / $273.02	Facility	AS	$273.02	$273.02	$273.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,039.76 / $15,838.63 / $18,619.91	Facility		$12,039.76	$15,838.63	$18,619.91
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