Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.38 / $7,920.26 / $20,400.00	Facility		$851.38	$7,920.26	$20,400.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,253.57 / $18,070.95 / $20,355.00	Facility	50	$4,253.57	$18,070.95	$20,355.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $747.23 / $1,063.89 / $1,197.83	Professional		$747.23	$1,063.89	$1,197.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $692.18 / $940.44 / $1,488.19	Facility		$692.18	$940.44	$1,488.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $617.32 / $909.19 / $942.48	Facility		$617.32	$909.19	$942.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $692.18 / $1,153.52 / $1,488.19	Facility		$692.18	$1,153.52	$1,488.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,334.20 / $21,141.87 / $25,621.76	Facility		$15,334.20	$21,141.87	$25,621.76
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $23,001.30 / $31,712.81 / $38,432.64	Facility	50	$23,001.30	$31,712.81	$38,432.64
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00