Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,072.68 / $4,704.00 / $8,728.00	Facility		$1,072.68	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $790.35 / $1,147.92 / $1,292.45	Professional		$790.35	$1,147.92	$1,292.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $497.81 / $833.67 / $1,399.41	Facility		$497.81	$833.67	$1,399.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $565.21 / $864.97 / $1,019.07	Facility		$565.21	$864.97	$1,019.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $647.91 / $1,084.71 / $2,724.00	Facility		$647.91	$1,084.71	$2,724.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,846.16 / $6,142.31 / $7,227.91	Facility		$4,846.16	$6,142.31	$7,227.91
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,113.00	Facility		$1,981.00	$9,074.00	$12,113.00