Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.46 / $4,704.00 / $8,728.00	Facility		$183.46	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.83 / $190.72 / $214.74	Professional		$133.83	$190.72	$214.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $110.80 / $172.79 / $241.58	Facility		$110.80	$172.79	$241.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $126.42 / $163.04 / $176.21	Facility		$126.42	$163.04	$176.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $110.80 / $184.65 / $238.22	Facility		$110.80	$184.65	$238.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $461.37 / $461.37 / $461.37	Facility		$461.37	$461.37	$461.37
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00