Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,044.02 / $7,920.26 / $53,206.78	Facility		$1,044.02	$7,920.26	$53,206.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $760.05 / $1,083.15 / $1,219.52	Professional		$760.05	$1,083.15	$1,219.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $630.10 / $1,006.00 / $1,379.14	Facility		$630.10	$1,006.00	$1,379.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $715.61 / $925.87 / $1,005.00	Facility		$715.61	$925.87	$1,005.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $630.10 / $1,160.58 / $1,354.72	Facility		$630.10	$1,160.58	$1,354.72
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $160.63 / $160.63 / $160.63	Facility	AS	$160.63	$160.63	$160.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,622.77 / $2,622.77 / $2,622.77	Facility		$2,622.77	$2,622.77	$2,622.77
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