Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.52 / $6,816.00 / $24,447.00	Facility		$245.52	$6,816.00	$24,447.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $662.92 / $726.33 / $811.74	Facility	52	$662.92	$726.33	$811.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,058.44 / $1,507.53 / $1,697.33	Professional		$1,058.44	$1,507.53	$1,697.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $936.12 / $1,522.83 / $2,121.48	Facility		$936.12	$1,522.83	$2,121.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $937.02 / $1,289.38 / $1,507.50	Facility		$937.02	$1,289.38	$1,507.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $936.12 / $1,680.16 / $9,999.15	Facility		$936.12	$1,680.16	$9,999.15
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $249.51 / $249.51 / $249.51	Facility	80	$249.51	$249.51	$249.51
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $212.08 / $212.08 / $212.08	Facility	AS	$212.08	$212.08	$212.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23,713.19 / $31,052.21 / $38,534.69	Facility		$23,713.19	$31,052.21	$38,534.69
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00