Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,376.71 / $13,042.97 / $21,735.00	Facility		$2,376.71	$13,042.97	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,257.23 / $2,615.36 / $2,905.96	Professional		$1,257.23	$2,615.36	$2,905.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,257.23 / $1,948.71 / $3,382.14	Facility		$1,257.23	$1,948.71	$3,382.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,685.09 / $2,330.26 / $2,491.73	Facility		$1,685.09	$2,330.26	$2,491.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,527.46 / $2,923.72 / $10,990.00	Facility		$1,527.46	$2,923.72	$10,990.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $467.80 / $467.80 / $467.80	Facility	80	$467.80	$467.80	$467.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,762.34 / $13,653.30 / $16,115.95	Facility		$10,762.34	$13,653.30	$16,115.95
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