Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,197.11 / $9,972.00 / $20,400.00	Facility		$2,197.11	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,583.32 / $2,259.55 / $2,544.03	Professional		$1,583.32	$2,259.55	$2,544.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,156.02 / $1,926.51 / $2,758.29	Facility		$1,156.02	$1,926.51	$2,758.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,360.96 / $1,842.29 / $2,007.32	Facility		$1,360.96	$1,842.29	$2,007.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,156.02 / $2,195.35 / $2,559.71	Facility		$1,156.02	$2,195.35	$2,559.71
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