Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,116.62 / $9,972.00 / $20,400.00	Facility		$5,116.62	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,322.06 / $6,202.74 / $6,983.66	Professional		$4,322.06	$6,202.74	$6,983.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $3,771.10 / $5,784.83 / $8,107.87	Facility		$3,771.10	$5,784.83	$8,107.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,849.84 / $5,184.33 / $5,446.32	Facility		$3,849.84	$5,184.33	$5,446.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,771.10 / $6,127.11 / $7,770.41	Facility		$3,771.10	$6,127.11	$7,770.41
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $4,038.59 / $4,038.59 / $4,038.59	Facility	62	$4,038.59	$4,038.59	$4,038.59
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $1,033.88 / $1,033.88 / $1,033.88	Facility	80	$1,033.88	$1,033.88	$1,033.88
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $878.80 / $878.80 / $878.80	Facility	AS	$878.80	$878.80	$878.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,061.38 / $14,061.38 / $14,061.38	Facility		$14,061.38	$14,061.38	$14,061.38
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $21,092.07 / $21,092.07 / $21,092.07	Facility	50	$21,092.07	$21,092.07	$21,092.07
United Facility/Professional Facility Modifier Low / Median / High Price $2,542.35 / $15,055.00 / $24,231.00	Facility		$2,542.35	$15,055.00	$24,231.00