Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,055.53 / $2,747.00 / $7,920.26	Facility		$1,055.53	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $824.09 / $1,161.76 / $1,322.51	Professional		$824.09	$1,161.76	$1,322.51
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $614.40 / $1,037.17 / $1,525.39	Facility		$614.40	$1,037.17	$1,525.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $766.96 / $1,003.89 / $1,067.98	Facility		$766.96	$1,003.89	$1,067.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $614.40 / $1,153.32 / $1,504.59	Facility		$614.40	$1,153.32	$1,504.59
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $204.80 / $204.80 / $204.80	Facility	80	$204.80	$204.80	$204.80
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $174.08 / $174.08 / $174.08	Facility	AS	$174.08	$174.08	$174.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,816.16 / $2,816.16 / $2,816.16	Facility		$2,816.16	$2,816.16	$2,816.16
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