Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,502.92 / $7,920.26 / $13,746.00	Facility		$1,502.92	$7,920.26	$13,746.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,961.22 / $6,961.22 / $6,961.22	Facility	50	$6,961.22	$6,961.22	$6,961.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $979.62 / $1,404.72 / $1,590.44	Professional		$979.62	$1,404.72	$1,590.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $918.41 / $1,313.33 / $1,974.58	Facility		$918.41	$1,313.33	$1,974.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $851.75 / $1,160.25 / $1,218.06	Facility		$851.75	$1,160.25	$1,218.06
Providence Facility/Professional Facility Modifier Low / Median / High Price $918.41 / $1,509.60 / $6,246.00	Facility		$918.41	$1,509.60	$6,246.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,277.96 / $10,794.36 / $14,018.87	Facility		$8,277.96	$10,794.36	$14,018.87
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $12,416.96 / $16,191.54 / $21,028.31	Facility	50	$12,416.96	$16,191.54	$21,028.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,113.00	Facility		$1,981.00	$9,074.00	$12,113.00