Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $6,025.60 / $17,378.01	Facility		$741.31	$6,025.60	$17,378.01
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	22	$2,511.89	$2,511.89	$2,511.89
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,265.80 / $5,623.41 / $21,379.62	Facility	50	$4,265.80	$5,623.41	$21,379.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $660.69 / $891.25	Professional		$501.19	$660.69	$891.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $812.83 / $6,025.60	Facility		$457.09	$812.83	$6,025.60
Moda Health Facility/Professional Facility Modifier 22 Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	22	$2,511.89	$2,511.89	$2,511.89
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $4,265.80 / $5,623.41 / $21,379.62	Facility	50	$4,265.80	$5,623.41	$21,379.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $724.44 / $977.24	Facility		$616.60	$724.44	$977.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $724.44 / $1,202.26	Facility		$426.58	$724.44	$1,202.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,135.61 / $21,379.62 / $25,703.96	Facility		$15,135.61	$21,379.62	$25,703.96
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $22,908.68 / $32,359.37 / $38,904.51	Facility	50	$22,908.68	$32,359.37	$38,904.51
United Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $13,182.57 / $30,902.95	Facility		$2,137.96	$13,182.57	$30,902.95