Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.37 / $2,659.00 / $7,920.26	Facility		$295.37	$2,659.00	$7,920.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $147.68 / $178.27 / $341.06	Facility	52	$147.68	$178.27	$341.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $273.89 / $402.41 / $670.61	Professional		$273.89	$402.41	$670.61
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $218.23 / $422.38 / $802.40	Facility		$218.23	$422.38	$802.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $285.79 / $503.84 / $603.91	Facility		$285.79	$503.84	$603.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $218.23 / $469.19 / $1,738.00	Facility		$218.23	$469.19	$1,738.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,032.32 / $5,176.14 / $6,353.74	Facility		$4,032.32	$5,176.14	$6,353.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00