Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,348.96 / $13,182.57	Facility		$1,000.00	$1,348.96	$13,182.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,122.02 / $1,348.96	Professional		$870.96	$1,122.02	$1,348.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $870.96 / $1,513.56	Facility		$537.03	$870.96	$1,513.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $977.24 / $1,071.52	Facility		$724.44	$977.24	$1,071.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $758.58 / $1,258.93	Facility		$501.19	$758.58	$1,258.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,488.17 / $20,892.96 / $25,703.96	Facility		$15,488.17	$20,892.96	$25,703.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $17,782.79 / $38,018.94	Facility		$2,884.03	$17,782.79	$38,018.94