Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,245.81 / $5,116.62 / $7,920.26	Facility		$2,245.81	$5,116.62	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,648.70 / $2,376.51 / $2,675.71	Professional		$1,648.70	$2,376.51	$2,675.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,360.67 / $2,075.01 / $2,925.44	Facility		$1,360.67	$2,075.01	$2,925.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,469.49 / $1,995.26 / $2,138.64	Facility		$1,469.49	$1,995.26	$2,138.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,360.67 / $2,267.56 / $2,886.95	Facility		$1,360.67	$2,267.56	$2,886.95
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $340.18 / $340.18 / $340.18	Facility	AS	$340.18	$340.18	$340.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,403.45 / $5,403.45 / $5,403.45	Facility		$5,403.45	$5,403.45	$5,403.45
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