Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,225.47 / $11,652.00 / $23,856.49	Facility		$1,225.47	$11,652.00	$23,856.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $888.50 / $1,262.41 / $1,421.35	Professional		$888.50	$1,262.41	$1,421.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $734.64 / $1,145.67 / $1,579.48	Facility		$734.64	$1,145.67	$1,579.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $805.24 / $1,066.64 / $1,155.08	Facility		$805.24	$1,066.64	$1,155.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $734.64 / $1,224.28 / $1,508.73	Facility		$734.64	$1,224.28	$1,508.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,928.04 / $36,273.58 / $43,569.74	Facility		$27,928.04	$36,273.58	$43,569.74
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $26,100.00 / $51,981.00	Facility		$3,340.00	$26,100.00	$51,981.00