Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.54 / $2,235.48 / $7,920.26	Facility		$240.54	$2,235.48	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,627.55 / $2,346.48 / $2,641.90	Professional		$1,627.55	$2,346.48	$2,641.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,360.80 / $2,098.77 / $2,925.72	Facility		$1,360.80	$2,098.77	$2,925.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,470.94 / $1,957.15 / $2,114.52	Facility		$1,470.94	$1,957.15	$2,114.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,360.80 / $2,267.77 / $2,923.97	Facility		$1,360.80	$2,267.77	$2,923.97
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,555.81 / $1,555.81 / $1,555.81	Facility	62	$1,555.81	$1,555.81	$1,555.81
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $398.29 / $398.29 / $398.29	Facility	80	$398.29	$398.29	$398.29
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $338.54 / $338.54 / $338.54	Facility	AS	$338.54	$338.54	$338.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,453.16 / $5,453.16 / $5,453.16	Facility		$5,453.16	$5,453.16	$5,453.16
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