Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $7,943.28 / $13,803.84	Facility		$1,949.84	$7,943.28	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,737.80 / $2,238.72	Professional		$758.58	$1,737.80	$2,238.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,949.84 / $13,803.84	Facility		$1,148.15	$1,949.84	$13,803.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,698.24 / $1,949.84	Facility		$1,412.54	$1,698.24	$1,949.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,148.15 / $2,187.76	Facility		$758.58	$1,148.15	$2,187.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44,668.36 / $58,884.37 / $72,443.60	Facility		$44,668.36	$58,884.37	$72,443.60
United Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $51,286.14 / $79,432.82	Facility		$4,265.80	$51,286.14	$79,432.82