Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,311.02 / $10,347.48 / $20,400.00	Facility		$2,311.02	$10,347.48	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,674.82 / $2,393.94 / $2,695.34	Professional		$1,674.82	$2,393.94	$2,695.34
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,432.41 / $2,187.98 / $3,079.68	Facility		$1,432.41	$2,187.98	$3,079.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,476.76 / $1,990.30 / $2,123.23	Facility		$1,476.76	$1,990.30	$2,123.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,432.41 / $2,387.11 / $3,079.68	Facility		$1,432.41	$2,387.11	$3,079.68
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $402.27 / $402.27 / $402.27	Facility	80	$402.27	$402.27	$402.27
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $341.93 / $341.93 / $341.93	Facility	AS	$341.93	$341.93	$341.93
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 / $22,956.00	Facility		$2,912.00	$16,268.00	$22,956.00