Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,777.22 / $12,274.80 / $21,735.00	Facility		$2,777.22	$12,274.80	$21,735.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.40 / $2,620.75 / $2,911.94	Professional		$1,258.40	$2,620.75	$2,911.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,258.40 / $1,963.74 / $3,383.99	Facility		$1,258.40	$1,963.74	$3,383.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,685.58 / $2,324.40 / $2,498.42	Facility		$1,685.58	$2,324.40	$2,498.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,587.07 / $2,933.36 / $10,990.00	Facility		$1,587.07	$2,933.36	$10,990.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $469.34 / $469.34 / $469.34	Facility	80	$469.34	$469.34	$469.34
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 / $22,956.00	Facility		$2,912.00	$16,268.00	$22,956.00