Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,320.96 / $4,962.67 / $15,341.00	Facility		$1,320.96	$4,962.67	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $972.59 / $1,410.39 / $1,587.95	Professional		$972.59	$1,410.39	$1,587.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $737.31 / $1,191.83 / $1,721.53	Facility		$737.31	$1,191.83	$1,721.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $844.10 / $1,130.58 / $1,260.94	Facility		$844.10	$1,130.58	$1,260.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $800.71 / $1,334.38 / $1,661.45	Facility		$800.71	$1,334.38	$1,661.45
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $198.65 / $198.65 / $198.65	Facility	AS	$198.65	$198.65	$198.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,107.19 / $3,107.19 / $3,107.19	Facility		$3,107.19	$3,107.19	$3,107.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00