Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,368.82 / $3,828.88 / $13,320.00	Facility		$1,368.82	$3,828.88	$13,320.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,669.24 / $5,270.76 / $14,082.50	Facility	50	$4,669.24	$5,270.76	$14,082.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,227.27 / $1,769.38 / $1,998.26	Professional		$1,227.27	$1,769.38	$1,998.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,060.44 / $1,665.51 / $2,597.23	Facility		$1,060.44	$1,665.51	$2,597.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,221.96 / $1,511.64 / $1,794.26	Facility		$1,221.96	$1,511.64	$1,794.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,060.44 / $1,957.33 / $5,626.00	Facility		$1,060.44	$1,957.33	$5,626.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $245.94 / $245.94 / $245.94	Facility	AS	$245.94	$245.94	$245.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $22,930.89 / $30,090.09 / $37,333.90	Facility		$22,930.89	$30,090.09	$37,333.90
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $34,396.33 / $45,135.14 / $56,000.85	Facility	50	$34,396.33	$45,135.14	$56,000.85
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00