Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,674.67 / $9,972.00 / $20,400.00	Facility		$1,674.67	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,214.30 / $1,741.40 / $1,960.65	Professional		$1,214.30	$1,741.40	$1,960.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $876.45 / $1,460.60 / $2,008.55	Facility		$876.45	$1,460.60	$2,008.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,021.33 / $1,407.96 / $1,538.32	Facility		$1,021.33	$1,407.96	$1,538.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $876.45 / $1,610.48 / $1,952.18	Facility		$876.45	$1,610.48	$1,952.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $289.98 / $289.98 / $289.98	Facility	80	$289.98	$289.98	$289.98
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $246.48 / $246.48 / $246.48	Facility	AS	$246.48	$246.48	$246.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,724.73 / $8,924.50 / $21,189.66	Facility		$3,724.73	$8,924.50	$21,189.66
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00