Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,714.00 / $2,747.00 / $7,920.26	Facility		$1,714.00	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,415.80 / $2,043.85 / $2,301.17	Professional		$1,415.80	$2,043.85	$2,301.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,159.74 / $1,777.65 / $2,493.44	Facility		$1,159.74	$1,777.65	$2,493.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,257.28 / $1,701.13 / $1,830.44	Facility		$1,257.28	$1,701.13	$1,830.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,159.74 / $1,932.71 / $2,464.87	Facility		$1,159.74	$1,932.71	$2,464.87
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $290.49 / $290.49 / $290.49	Facility	AS	$290.49	$290.49	$290.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,611.99 / $4,611.99 / $4,611.99	Facility		$4,611.99	$4,611.99	$4,611.99
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