Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,080.86 / $7,920.26 / $15,978.56	Facility		$2,080.86	$7,920.26	$15,978.56
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,621.83 / $20,535.00 / $39,960.81	Facility	50	$4,621.83	$20,535.00	$39,960.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,871.70 / $2,700.92 / $3,058.14	Professional		$1,871.70	$2,700.92	$3,058.14
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,628.92 / $2,692.38 / $4,022.20	Facility		$1,628.92	$2,692.38	$4,022.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,920.05 / $2,333.76 / $2,905.79	Facility		$1,920.05	$2,333.76	$2,905.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,628.92 / $2,979.32 / $7,952.00	Facility		$1,628.92	$2,979.32	$7,952.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $374.80 / $374.80 / $374.80	Facility	AS	$374.80	$374.80	$374.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $37,457.72 / $54,022.05 / $65,967.95	Facility		$37,457.72	$54,022.05	$65,967.95
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $56,186.58 / $81,033.08 / $98,951.93	Facility	50	$56,186.58	$81,033.08	$98,951.93
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