Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,833.85 / $12,274.80 / $21,735.00	Facility		$2,833.85	$12,274.80	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,061.85 / $2,950.13 / $3,321.55	Professional		$2,061.85	$2,950.13	$3,321.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,757.78 / $2,617.63 / $3,779.23	Facility		$1,757.78	$2,617.63	$3,779.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,754.87 / $2,410.88 / $2,626.40	Facility		$1,754.87	$2,410.88	$2,626.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,757.78 / $2,929.34 / $3,779.23	Facility		$1,757.78	$2,929.34	$3,779.23
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $496.83 / $496.83 / $496.83	Facility	80	$496.83	$496.83	$496.83
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $422.31 / $422.31 / $422.31	Facility	AS	$422.31	$422.31	$422.31
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