Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.21 / $2,747.00 / $7,920.26	Facility		$165.21	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.29 / $189.99 / $213.91	Professional		$133.29	$189.99	$213.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $110.33 / $172.06 / $239.73	Facility		$110.33	$172.06	$239.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $162.37 / $175.54	Facility		$125.00	$162.37	$175.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $110.33 / $183.86 / $237.21	Facility		$110.33	$183.86	$237.21
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