Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $4,684.68 / $7,920.26	Facility		$988.00	$4,684.68	$7,920.26
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $7,199.14 / $7,199.14 / $7,199.14	Facility	50	$7,199.14	$7,199.14	$7,199.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $895.38 / $1,107.02 / $1,344.85	Professional		$895.38	$1,107.02	$1,344.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $526.59 / $780.12 / $1,202.67	Facility		$526.59	$780.12	$1,202.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $547.20 / $917.95 / $1,756.22	Facility		$547.20	$917.95	$1,756.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $565.99 / $996.74 / $2,833.00	Facility		$565.99	$996.74	$2,833.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,536.02 / $8,364.56 / $10,637.18	Facility		$6,536.02	$8,364.56	$10,637.18
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $9,804.03 / $12,546.84 / $15,955.77	Facility	50	$9,804.03	$12,546.84	$15,955.77
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00