Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $3,624.44 / $7,920.26	Facility		$2,747.00	$3,624.44	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,362.44 / $3,400.99 / $3,829.17	Professional		$2,362.44	$3,400.99	$3,829.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,947.48 / $2,989.91 / $4,187.08	Facility		$1,947.48	$2,989.91	$4,187.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,136.65 / $2,877.65 / $3,082.67	Facility		$2,136.65	$2,877.65	$3,082.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,947.48 / $3,245.48 / $4,152.24	Facility		$1,947.48	$3,245.48	$4,152.24
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $489.25 / $489.25 / $489.25	Facility	AS	$489.25	$489.25	$489.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,836.35 / $7,836.35 / $7,836.35	Facility		$7,836.35	$7,836.35	$7,836.35
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $11,754.53 / $11,754.53 / $11,754.53	Facility	50	$11,754.53	$11,754.53	$11,754.53
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