Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $3,891.43 / $7,920.26	Facility		$2,747.00	$3,891.43	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,525.67 / $3,558.10 / $4,050.42	Professional		$2,525.67	$3,558.10	$4,050.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,135.07 / $3,271.29 / $4,827.00	Facility		$2,135.07	$3,271.29	$4,827.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,386.65 / $3,076.73 / $3,327.92	Facility		$2,386.65	$3,076.73	$3,327.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,135.07 / $3,558.09 / $4,590.39	Facility		$2,135.07	$3,558.09	$4,590.39
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $628.78 / $628.78 / $628.78	Facility	80	$628.78	$628.78	$628.78
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $534.46 / $534.46 / $534.46	Facility	AS	$534.46	$534.46	$534.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,842.51 / $8,842.51 / $8,842.51	Facility		$8,842.51	$8,842.51	$8,842.51
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