Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,471.90 / $5,649.00 / $15,341.00	Facility		$1,471.90	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,069.39 / $1,538.69 / $1,732.41	Professional		$1,069.39	$1,538.69	$1,732.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $914.08 / $1,367.56 / $1,965.27	Facility		$914.08	$1,367.56	$1,965.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $920.55 / $1,245.81 / $1,354.07	Facility		$920.55	$1,245.81	$1,354.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $914.08 / $1,582.74 / $3,274.00	Facility		$914.08	$1,582.74	$3,274.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $255.16 / $255.16 / $255.16	Facility	80	$255.16	$255.16	$255.16
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