Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.92 / $451.70 / $7,920.26	Facility		$0.92	$451.70	$7,920.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $208.87 / $225.85 / $251.51	Facility	52	$208.87	$225.85	$251.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $326.31 / $460.22 / $518.16	Professional		$326.31	$460.22	$518.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $306.47 / $476.69 / $658.91	Facility		$306.47	$476.69	$658.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $293.95 / $397.50 / $427.72	Facility		$293.95	$397.50	$427.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $306.47 / $507.96 / $658.91	Facility		$306.47	$507.96	$658.91
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $316.18 / $316.18 / $316.18	Facility	62	$316.18	$316.18	$316.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $80.94 / $80.94 / $80.94	Facility	80	$80.94	$80.94	$80.94
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $68.80 / $68.80 / $68.80	Facility	AS	$68.80	$68.80	$68.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,116.19 / $1,116.19 / $1,116.19	Facility		$1,116.19	$1,116.19	$1,116.19
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00