Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,029.54 / $14,327.24 / $21,735.00	Facility		$2,029.54	$14,327.24	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,563.78 / $2,232.59 / $2,513.67	Professional		$1,563.78	$2,232.59	$2,513.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,139.83 / $1,899.53 / $2,729.59	Facility		$1,139.83	$1,899.53	$2,729.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,361.93 / $1,883.37 / $1,980.84	Facility		$1,361.93	$1,883.37	$1,980.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,139.83 / $2,160.23 / $2,524.53	Facility		$1,139.83	$2,160.23	$2,524.53
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $374.26 / $374.26 / $374.26	Facility	80	$374.26	$374.26	$374.26
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $318.12 / $318.12 / $318.12	Facility	AS	$318.12	$318.12	$318.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23,713.19 / $31,052.21 / $38,534.69	Facility		$23,713.19	$31,052.21	$38,534.69
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $20,708.00 / $39,102.35	Facility		$3,028.00	$20,708.00	$39,102.35