Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,472.13 / $9,312.86 / $16,595.70	Facility		$1,472.13	$9,312.86	$16,595.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,136.25 / $1,623.20 / $1,827.56	Professional		$1,136.25	$1,623.20	$1,827.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $826.14 / $1,376.76 / $1,960.42	Facility		$826.14	$1,376.76	$1,960.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $980.14 / $1,330.55 / $1,441.17	Facility		$980.14	$1,330.55	$1,441.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $826.14 / $1,698.34 / $7,952.00	Facility		$826.14	$1,698.34	$7,952.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $271.73 / $271.73 / $271.73	Facility	80	$271.73	$271.73	$271.73
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $230.97 / $230.97 / $230.97	Facility	AS	$230.97	$230.97	$230.97
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