Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,787.24 / $12,274.80 / $21,735.00	Facility		$2,787.24	$12,274.80	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,262.35 / $2,629.39 / $2,921.54	Professional		$1,262.35	$2,629.39	$2,921.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,262.35 / $1,975.47 / $3,387.70	Facility		$1,262.35	$1,975.47	$3,387.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,694.30 / $2,340.98 / $2,505.80	Facility		$1,694.30	$2,340.98	$2,505.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,592.64 / $2,947.01 / $10,990.00	Facility		$1,592.64	$2,947.01	$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