Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,404.80 / $7,920.26 / $18,360.00	Facility		$1,404.80	$7,920.26	$18,360.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,089.03 / $1,555.57 / $1,751.41	Professional		$1,089.03	$1,555.57	$1,751.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $786.26 / $1,310.30 / $1,869.71	Facility		$786.26	$1,310.30	$1,869.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $929.27 / $1,263.35 / $1,383.55	Facility		$929.27	$1,263.35	$1,383.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $786.26 / $1,616.70 / $7,952.00	Facility		$786.26	$1,616.70	$7,952.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,624.30 / $17,810.43 / $21,600.03	Facility		$13,624.30	$17,810.43	$21,600.03
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00