Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,121.23 / $7,920.26 / $20,400.00	Facility		$1,121.23	$7,920.26	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $828.54 / $1,205.15 / $1,356.99	Professional		$828.54	$1,205.15	$1,356.99
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $576.57 / $1,001.33 / $1,449.66	Facility		$576.57	$1,001.33	$1,449.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $652.95 / $964.13 / $1,065.30	Facility		$652.95	$964.13	$1,065.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $674.26 / $1,215.11 / $5,626.00	Facility		$674.26	$1,215.11	$5,626.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,527.70 / $20,006.47 / $24,937.25	Facility		$15,527.70	$20,006.47	$24,937.25
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