Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,261.50 / $11,063.64 / $18,967.97	Facility		$1,261.50	$11,063.64	$18,967.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,209.61 / $1,731.10 / $1,949.04	Professional		$1,209.61	$1,731.10	$1,949.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $810.67 / $1,414.27 / $2,096.48	Facility		$810.67	$1,414.27	$2,096.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,009.98 / $1,420.90 / $1,574.50	Facility		$1,009.98	$1,420.90	$1,574.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $810.67 / $1,674.75 / $2,005.38	Facility		$810.67	$1,674.75	$2,005.38
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