Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $4,917.10 / $7,920.26	Facility		$2,747.00	$4,917.10	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,188.97 / $4,555.53 / $5,129.07	Professional		$3,188.97	$4,555.53	$5,129.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,313.01 / $3,854.63 / $5,420.31	Facility		$2,313.01	$3,854.63	$5,420.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,808.19 / $3,818.65 / $4,038.76	Facility		$2,808.19	$3,818.65	$4,038.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,313.01 / $4,297.08 / $5,131.43	Facility		$2,313.01	$4,297.08	$5,131.43
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $761.50 / $761.50 / $761.50	Facility	80	$761.50	$761.50	$761.50
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $647.28 / $647.28 / $647.28	Facility	AS	$647.28	$647.28	$647.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,350.83 / $10,350.83 / $10,350.83	Facility		$10,350.83	$10,350.83	$10,350.83
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00