Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,665.13 / $7,920.26 / $13,856.92	Facility		$1,665.13	$7,920.26	$13,856.92
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $769.33 / $832.57 / $917.67	Facility	52	$769.33	$832.57	$917.67
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $307.73 / $333.03 / $367.07	Facility	53	$307.73	$333.03	$367.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,191.78 / $1,690.37 / $1,924.27	Professional		$1,191.78	$1,690.37	$1,924.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $733.05 / $1,468.90 / $2,208.48	Facility		$733.05	$1,468.90	$2,208.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,046.17 / $1,451.81 / $1,555.74	Facility		$1,046.17	$1,451.81	$1,555.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $733.05 / $1,601.92 / $2,208.48	Facility		$733.05	$1,601.92	$2,208.48
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,160.83 / $1,160.83 / $1,160.83	Facility	62	$1,160.83	$1,160.83	$1,160.83
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $297.17 / $297.17 / $297.17	Facility	80	$297.17	$297.17	$297.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,130.20 / $4,130.20 / $4,130.20	Facility		$4,130.20	$4,130.20	$4,130.20
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00