Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.52 / $2,747.00 / $7,920.26	Facility		$245.52	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,257.46 / $3,199.96 / $3,642.73	Professional		$2,257.46	$3,199.96	$3,642.73
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,903.53 / $2,817.05 / $4,092.59	Facility		$1,903.53	$2,817.05	$4,092.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,983.87 / $2,750.01 / $2,915.17	Facility		$1,983.87	$2,750.01	$2,915.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,903.53 / $3,049.01 / $4,067.09	Facility		$1,903.53	$3,049.01	$4,067.09
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,180.14 / $2,180.14 / $2,180.14	Facility	62	$2,180.14	$2,180.14	$2,180.14
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $558.12 / $558.12 / $558.12	Facility	80	$558.12	$558.12	$558.12
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $474.40 / $474.40 / $474.40	Facility	AS	$474.40	$474.40	$474.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,587.89 / $7,587.89 / $7,587.89	Facility		$7,587.89	$7,587.89	$7,587.89
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