Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,152.73 / $2,747.00 / $7,920.26	Facility		$2,152.73	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,746.54 / $2,512.60 / $2,828.94	Professional		$1,746.54	$2,512.60	$2,828.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,451.92 / $2,236.65 / $3,121.63	Facility		$1,451.92	$2,236.65	$3,121.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,586.74 / $2,127.60 / $2,280.01	Facility		$1,586.74	$2,127.60	$2,280.01
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,451.92 / $2,419.62 / $3,111.87	Facility		$1,451.92	$2,419.62	$3,111.87
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,665.73 / $1,665.73 / $1,665.73	Facility	62	$1,665.73	$1,665.73	$1,665.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,863.04 / $5,863.04 / $5,863.04	Facility		$5,863.04	$5,863.04	$5,863.04
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