Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $7,920.26 / $20,400.00	Facility		$2,747.00	$7,920.26	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $189.30 / $189.30	Professional		$84.00	$189.30	$189.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $300.67 / $375.27 / $422.52	Professional		$300.67	$375.27	$422.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $189.30 / $198.77 / $407.00	Facility		$189.30	$198.77	$407.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $229.98 / $2,995.90 / $4,309.97	Facility		$229.98	$2,995.90	$4,309.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $189.30 / $270.70 / $407.00	Facility		$189.30	$270.70	$407.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $223.33 / $314.91 / $338.20	Professional		$223.33	$314.91	$338.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,762.43 / $14,215.14 / $17,324.30	Facility		$10,762.43	$14,215.14	$17,324.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $266.95 / $404.51 / $517.16	Professional		$266.95	$404.51	$517.16
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
United Facility/Professional Professional Modifier Low / Median / High Price $227.91 / $330.70 / $524.49	Professional		$227.91	$330.70	$524.49