Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,153.38 / $7,920.26 / $20,400.00	Facility		$2,153.38	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,727.90 / $2,469.46 / $2,780.36	Professional		$1,727.90	$2,469.46	$2,780.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,479.75 / $2,265.54 / $3,181.46	Facility		$1,479.75	$2,265.54	$3,181.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,450.80 / $2,071.08 / $2,197.08	Facility		$1,450.80	$2,071.08	$2,197.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,479.75 / $2,466.00 / $3,181.46	Facility		$1,479.75	$2,466.00	$3,181.46
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $415.12 / $415.12 / $415.12	Facility	80	$415.12	$415.12	$415.12
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $352.85 / $352.85 / $352.85	Facility	AS	$352.85	$352.85	$352.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,671.70 / $18,246.18 / $21,922.68	Facility		$13,671.70	$18,246.18	$21,922.68
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00