Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $397.73 / $2,747.00 / $7,920.26	Facility		$397.73	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.85 / $435.15 / $495.37	Professional		$309.85	$435.15	$495.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $262.62 / $437.66 / $843.21	Facility		$262.62	$437.66	$843.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $329.32 / $402.67 / $661.96	Facility		$329.32	$402.67	$661.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $262.62 / $514.00 / $818.55	Facility		$262.62	$514.00	$818.55
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $302.63 / $302.63 / $302.63	Facility	62	$302.63	$302.63	$302.63
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $77.47 / $77.47 / $77.47	Facility	80	$77.47	$77.47	$77.47
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $65.84 / $65.84 / $65.84	Facility	AS	$65.84	$65.84	$65.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,769.21 / $1,769.21 / $1,769.21	Facility		$1,769.21	$1,769.21	$1,769.21
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,653.82 / $2,653.82 / $2,653.82	Facility	50	$2,653.82	$2,653.82	$2,653.82
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