Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $872.48 / $4,962.67 / $12,193.46	Facility		$872.48	$4,962.67	$12,193.46
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,193.66 / $4,236.75 / $8,473.50	Facility	50	$2,193.66	$4,236.75	$8,473.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $712.00 / $1,023.31 / $1,152.14	Professional		$712.00	$1,023.31	$1,152.14
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $625.12 / $893.92 / $1,344.01	Facility		$625.12	$893.92	$1,344.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $594.88 / $838.84 / $905.84	Facility		$594.88	$838.84	$905.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $625.12 / $1,067.19 / $1,344.01	Facility		$625.12	$1,067.19	$1,344.01
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $145.13 / $145.13 / $145.13	Facility	AS	$145.13	$145.13	$145.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,539.09 / $11,747.31 / $14,269.30	Facility		$8,539.09	$11,747.31	$14,269.30
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $12,808.64 / $17,620.97 / $21,403.95	Facility	50	$12,808.64	$17,620.97	$21,403.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00