Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,659.59 / $6,606.93	Facility		$891.25	$1,659.59	$6,606.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility	50	$3,311.31	$3,311.31	$3,311.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,230.27 / $1,659.59	Professional		$954.99	$1,230.27	$1,659.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,096.48 / $2,238.72	Facility		$707.95	$1,096.48	$2,238.72
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $3,311.31 / $3,311.31 / $3,311.31	Facility	50	$3,311.31	$3,311.31	$3,311.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,230.27 / $1,318.26	Facility		$891.25	$1,230.27	$1,318.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $891.25 / $1,513.56	Facility		$645.65	$891.25	$1,513.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $12,022.64 / $14,125.38	Facility		$8,511.38	$12,022.64	$14,125.38
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $12,882.50 / $17,782.79 / $21,379.62	Facility	50	$12,882.50	$17,782.79	$21,379.62
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $13,182.57 / $26,302.68	Facility		$2,137.96	$13,182.57	$26,302.68