Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $747.15 / $6,044.39 / $22,454.88	Facility		$747.15	$6,044.39	$22,454.88
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,503.50 / $2,503.50 / $2,503.50	Facility	22	$2,503.50	$2,503.50	$2,503.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,253.57 / $5,579.00 / $21,567.63	Facility	50	$4,253.57	$5,579.00	$21,567.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $599.51 / $854.03 / $961.55	Professional		$599.51	$854.03	$961.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $553.87 / $963.93 / $1,298.49	Facility		$553.87	$963.93	$1,298.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $619.85 / $733.65 / $972.84	Facility		$619.85	$733.65	$972.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $553.87 / $987.32 / $5,626.00	Facility		$553.87	$987.32	$5,626.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,198.09 / $20,033.77 / $25,621.76	Facility		$15,198.09	$20,033.77	$25,621.76
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $22,797.14 / $30,050.66 / $38,432.64	Facility	50	$22,797.14	$30,050.66	$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