Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,986.48 / $2,747.00 / $7,920.26	Facility		$1,986.48	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,558.07 / $2,195.81 / $2,499.64	Professional		$1,558.07	$2,195.81	$2,499.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,315.56 / $2,047.23 / $2,982.28	Facility		$1,315.56	$2,047.23	$2,982.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,469.00 / $1,898.02 / $2,063.60	Facility		$1,469.00	$1,898.02	$2,063.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,315.56 / $2,192.38 / $2,828.45	Facility		$1,315.56	$2,192.38	$2,828.45
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $387.75 / $387.75 / $387.75	Facility	80	$387.75	$387.75	$387.75
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $329.59 / $329.59 / $329.59	Facility	AS	$329.59	$329.59	$329.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,446.02 / $5,446.02 / $5,446.02	Facility		$5,446.02	$5,446.02	$5,446.02
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,169.03 / $8,169.03 / $8,169.03	Facility	50	$8,169.03	$8,169.03	$8,169.03
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