Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $393.77 / $889.65 / $1,179.99	Facility		$393.77	$889.65	$1,179.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $731.14 / $771.68 / $1,368.00	Professional		$731.14	$771.68	$1,368.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,624.17 / $1,873.39 / $2,021.31	Professional		$1,624.17	$1,873.39	$2,021.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $731.14 / $1,022.70 / $1,571.95	Facility		$731.14	$1,022.70	$1,571.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $883.24 / $954.75 / $1,591.25	Facility		$883.24	$954.75	$1,591.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $731.14 / $1,104.05 / $1,766.48	Facility		$731.14	$1,104.05	$1,766.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,026.00 / $1,104.05 / $1,629.25	Professional		$1,026.00	$1,104.05	$1,629.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $883.24 / $883.24 / $883.24	Professional		$883.24	$883.24	$883.24
United Facility/Professional Professional Modifier Low / Median / High Price $883.24 / $883.24 / $1,015.73	Professional		$883.24	$883.24	$1,015.73