Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,559.63 / $7,920.26 / $16,697.71	Facility		$1,559.63	$7,920.26	$16,697.71
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,320.00 / $9,480.00 / $17,755.50	Facility	50	$6,320.00	$9,480.00	$17,755.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,272.75 / $1,835.65 / $2,069.92	Professional		$1,272.75	$1,835.65	$2,069.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,098.63 / $1,601.85 / $2,362.05	Facility		$1,098.63	$1,601.85	$2,362.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,073.65 / $1,467.68 / $1,598.62	Facility		$1,073.65	$1,467.68	$1,598.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,098.63 / $1,862.19 / $6,246.00	Facility		$1,098.63	$1,862.19	$6,246.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $255.87 / $255.87 / $255.87	Facility	AS	$255.87	$255.87	$255.87
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 $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00