Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $490.00 / $490.00	Facility		$490.00	$490.00	$490.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $322.00 / $2,332.21	Facility		$200.00	$322.00	$2,332.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $947.00	Facility		$100.00	$100.00	$947.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $260.00 / $400.00 / $800.00	Facility		$260.00	$400.00	$800.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $735.00 / $814.00	Facility		$650.00	$735.00	$814.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $209.00 / $691.21 / $1,206.20	Facility		$209.00	$691.21	$1,206.20