Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,576.64 / $2,747.00 / $7,920.26	Facility		$1,576.64	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,236.42 / $1,746.32 / $1,987.95	Professional		$1,236.42	$1,746.32	$1,987.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,046.60 / $1,622.19 / $2,353.80	Facility		$1,046.60	$1,622.19	$2,353.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,163.28 / $1,506.17 / $1,626.56	Facility		$1,163.28	$1,506.17	$1,626.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,046.60 / $1,744.18 / $2,250.21	Facility		$1,046.60	$1,744.18	$2,250.21
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $307.32 / $307.32 / $307.32	Facility	80	$307.32	$307.32	$307.32
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $261.23 / $261.23 / $261.23	Facility	AS	$261.23	$261.23	$261.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,306.79 / $4,306.79 / $4,306.79	Facility		$4,306.79	$4,306.79	$4,306.79
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $6,460.19 / $6,460.19 / $6,460.19	Facility	50	$6,460.19	$6,460.19	$6,460.19
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