Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,398.41 / $5,584.00 / $22,993.48	Facility		$1,398.41	$5,584.00	$22,993.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,128.96 / $1,619.56 / $1,823.46	Professional		$1,128.96	$1,619.56	$1,823.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $964.42 / $1,504.01 / $2,073.50	Facility		$964.42	$1,504.01	$2,073.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $984.50 / $1,335.55 / $1,427.77	Facility		$984.50	$1,335.55	$1,427.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $964.42 / $1,607.21 / $2,073.50	Facility		$964.42	$1,607.21	$2,073.50
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $269.81 / $269.81 / $269.81	Facility	80	$269.81	$269.81	$269.81
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $229.34 / $229.34 / $229.34	Facility	AS	$229.34	$229.34	$229.34
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