Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $4,244.72 / $7,920.26	Facility		$2,747.00	$4,244.72	$7,920.26
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $700.42 / $761.67 / $848.95	Facility	53	$700.42	$761.67	$848.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,757.13 / $3,911.57 / $4,452.81	Professional		$2,757.13	$3,911.57	$4,452.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,696.30 / $3,340.34 / $5,022.18	Facility		$1,696.30	$3,340.34	$5,022.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,466.94 / $3,358.69 / $3,540.28	Facility		$2,466.94	$3,358.69	$3,540.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,696.30 / $3,642.84 / $5,022.18	Facility		$1,696.30	$3,642.84	$5,022.18
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,651.41 / $2,651.41 / $2,651.41	Facility	62	$2,651.41	$2,651.41	$2,651.41
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $678.76 / $678.76 / $678.76	Facility	80	$678.76	$678.76	$678.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,273.69 / $9,273.69 / $9,273.69	Facility		$9,273.69	$9,273.69	$9,273.69
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