Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,195.88 / $9,972.00 / $22,251.25	Facility		$2,195.88	$9,972.00	$22,251.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,791.97 / $2,547.91 / $2,868.69	Professional		$1,791.97	$2,547.91	$2,868.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,658.25 / $2,586.04 / $3,565.24	Facility		$1,658.25	$2,586.04	$3,565.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,786.84 / $2,219.01 / $2,528.23	Facility		$1,786.84	$2,219.01	$2,528.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,658.25 / $2,808.92 / $3,565.24	Facility		$1,658.25	$2,808.92	$3,565.24
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $479.23 / $479.23 / $479.23	Facility	80	$479.23	$479.23	$479.23
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $407.35 / $407.35 / $407.35	Facility	AS	$407.35	$407.35	$407.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $22,740.27 / $29,241.94 / $36,485.06	Facility		$22,740.27	$29,241.94	$36,485.06
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $34,110.41 / $43,862.91 / $54,727.59	Facility	50	$34,110.41	$43,862.91	$54,727.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00