Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $580.10 / $1,203.22 / $13,320.00	Facility		$580.10	$1,203.22	$13,320.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $461.33 / $591.08 / $902.42	Facility	54	$461.33	$591.08	$902.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $516.61 / $777.99 / $1,131.61	Professional		$516.61	$777.99	$1,131.61
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $428.75 / $684.09 / $1,069.86	Facility		$428.75	$684.09	$1,069.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $505.72 / $824.65 / $976.86	Facility		$505.72	$824.65	$976.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $428.75 / $752.70 / $1,679.85	Facility		$428.75	$752.70	$1,679.85
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $925.70 / $925.70 / $925.70	Facility	54	$925.70	$925.70	$925.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,245.03 / $1,561.00 / $2,179.07	Facility		$1,245.03	$1,561.00	$2,179.07
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00