Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,785.37 / $16,620.00 / $30,136.54	Facility		$1,785.37	$16,620.00	$30,136.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,456.97 / $2,084.80 / $2,347.28	Professional		$1,456.97	$2,084.80	$2,347.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,246.30 / $1,943.60 / $2,679.55	Facility		$1,246.30	$1,943.60	$2,679.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,282.96 / $1,737.72 / $1,848.53	Facility		$1,282.96	$1,737.72	$1,848.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,246.30 / $2,076.96 / $2,679.55	Facility		$1,246.30	$2,076.96	$2,679.55
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $350.36 / $350.36 / $350.36	Facility	80	$350.36	$350.36	$350.36
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $297.81 / $297.81 / $297.81	Facility	AS	$297.81	$297.81	$297.81
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