Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,486.00 / $5,229.00 / $13,335.30	Facility		$1,486.00	$5,229.00	$13,335.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,325.47 / $1,910.50 / $2,151.03	Professional		$1,325.47	$1,910.50	$2,151.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,098.79 / $1,674.09 / $2,362.40	Facility		$1,098.79	$1,674.09	$2,362.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,191.86 / $1,614.03 / $1,723.24	Facility		$1,191.86	$1,614.03	$1,723.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,098.79 / $2,016.33 / $3,274.00	Facility		$1,098.79	$2,016.33	$3,274.00
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,260.21 / $1,260.21 / $1,260.21	Facility	62	$1,260.21	$1,260.21	$1,260.21
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $274.22 / $274.22 / $274.22	Facility	AS	$274.22	$274.22	$274.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,527.70 / $20,006.47 / $24,937.25	Facility		$15,527.70	$20,006.47	$24,937.25
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00