Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,525.17 / $12,274.80 / $21,735.00	Facility		$2,525.17	$12,274.80	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.46 / $2,385.71 / $2,650.80	Professional		$1,148.46	$2,385.71	$2,650.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,148.46 / $1,780.11 / $3,048.00	Facility		$1,148.46	$1,780.11	$3,048.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,517.94 / $2,099.11 / $2,267.94	Facility		$1,517.94	$2,099.11	$2,267.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,397.35 / $2,656.83 / $10,990.00	Facility		$1,397.35	$2,656.83	$10,990.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,762.34 / $13,653.30 / $19,565.63	Facility		$10,762.34	$13,653.30	$19,565.63
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