Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,483.24 / $2,747.00 / $7,920.26	Facility		$1,483.24	$2,747.00	$7,920.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $741.62 / $818.25 / $915.01	Facility	52	$741.62	$818.25	$915.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,193.91 / $1,707.64 / $1,922.64	Professional		$1,193.91	$1,707.64	$1,922.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $966.39 / $1,507.09 / $2,077.73	Facility		$966.39	$1,507.09	$2,077.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,056.21 / $1,422.01 / $1,521.57	Facility		$1,056.21	$1,422.01	$1,521.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $966.39 / $1,626.18 / $2,052.98	Facility		$966.39	$1,626.18	$2,052.98
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $288.18 / $288.18 / $288.18	Facility	80	$288.18	$288.18	$288.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,868.46 / $3,868.46 / $3,868.46	Facility		$3,868.46	$3,868.46	$3,868.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00