Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $405.63 / $2,659.00 / $7,920.26	Facility		$405.63	$2,659.00	$7,920.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $187.94 / $225.89 / $562.76	Facility	52	$187.94	$225.89	$562.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $347.24 / $510.18 / $1,094.35	Professional		$347.24	$510.18	$1,094.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $277.33 / $596.28 / $1,478.25	Facility		$277.33	$596.28	$1,478.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $363.14 / $861.62 / $1,099.08	Facility		$363.14	$861.62	$1,099.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $277.33 / $902.84 / $2,327.00	Facility		$277.33	$902.84	$2,327.00
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
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