Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,026.00 / $7,920.26 / $20,400.00	Facility		$3,026.00	$7,920.26	$20,400.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $21,541.88 / $21,541.88 / $21,541.88	Facility	50	$21,541.88	$21,541.88	$21,541.88
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,436.10 / $1,604.43 / $1,784.48	Facility	52	$1,436.10	$1,604.43	$1,784.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,321.39 / $3,324.39 / $3,742.93	Professional		$2,321.39	$3,324.39	$3,742.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,631.53 / $3,041.68 / $4,379.87	Facility		$1,631.53	$3,041.68	$4,379.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,870.76 / $2,751.00 / $2,921.20	Facility		$1,870.76	$2,751.00	$2,921.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,037.15 / $3,219.48 / $4,068.01	Facility		$2,037.15	$3,219.48	$4,068.01
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,152.04 / $2,152.04 / $2,152.04	Facility	62	$2,152.04	$2,152.04	$2,152.04
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $550.91 / $550.91 / $550.91	Facility	80	$550.91	$550.91	$550.91
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $468.28 / $468.28 / $468.28	Facility	AS	$468.28	$468.28	$468.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,171.41 / $10,830.87 / $24,898.13	Facility		$5,171.41	$10,830.87	$24,898.13
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $7,757.12 / $16,246.31 / $37,347.19	Facility	50	$7,757.12	$16,246.31	$37,347.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00