Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $424.33 / $2,747.00 / $7,920.26	Facility		$424.33	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $333.86 / $472.74 / $532.26	Professional		$333.86	$472.74	$532.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $273.88 / $427.12 / $588.84	Facility		$273.88	$427.12	$588.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $305.24 / $406.70 / $430.14	Facility		$305.24	$406.70	$430.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $273.88 / $469.26 / $588.84	Facility		$273.88	$469.26	$588.84
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $82.36 / $82.36 / $82.36	Facility	80	$82.36	$82.36	$82.36
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	AS	$70.00	$70.00	$70.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,117.97 / $1,117.97 / $1,117.97	Facility		$1,117.97	$1,117.97	$1,117.97
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