Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,995.74 / $9,972.00 / $20,400.00	Facility		$1,995.74	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,865.51 / $2,677.87 / $3,015.01	Professional		$1,865.51	$2,677.87	$3,015.01
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,622.56 / $2,379.40 / $3,488.50	Facility		$1,622.56	$2,379.40	$3,488.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,668.62 / $2,255.82 / $2,381.85	Facility		$1,668.62	$2,255.82	$2,381.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,622.56 / $2,704.00 / $3,488.50	Facility		$1,622.56	$2,704.00	$3,488.50
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $453.41 / $453.41 / $453.41	Facility	80	$453.41	$453.41	$453.41
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $385.40 / $385.40 / $385.40	Facility	AS	$385.40	$385.40	$385.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,761.83 / $19,243.91 / $24,411.82	Facility		$14,761.83	$19,243.91	$24,411.82
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $22,142.75 / $28,865.88 / $36,617.73	Facility	50	$22,142.75	$28,865.88	$36,617.73
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