Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,976.95 / $16,620.00 / $21,735.00	Facility		$1,976.95	$16,620.00	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,538.81 / $2,203.67 / $2,481.12	Professional		$1,538.81	$2,203.67	$2,481.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,315.63 / $2,051.71 / $2,828.60	Facility		$1,315.63	$2,051.71	$2,828.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,348.36 / $1,824.18 / $1,956.40	Facility		$1,348.36	$1,824.18	$1,956.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,315.63 / $2,192.50 / $2,828.60	Facility		$1,315.63	$2,192.50	$2,828.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $370.54 / $370.54 / $370.54	Facility	80	$370.54	$370.54	$370.54
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $314.95 / $314.95 / $314.95	Facility	AS	$314.95	$314.95	$314.95
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