Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.79 / $4,684.68 / $8,728.00	Facility		$494.79	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $420.43 / $782.67 / $2,048.57	Professional		$420.43	$782.67	$2,048.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $295.22 / $858.79 / $2,456.73	Facility		$295.22	$858.79	$2,456.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $483.12 / $1,621.16 / $1,851.64	Facility		$483.12	$1,621.16	$1,851.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $295.22 / $1,273.72 / $2,456.73	Facility		$295.22	$1,273.72	$2,456.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,993.29 / $6,338.31 / $7,624.85	Facility		$4,993.29	$6,338.31	$7,624.85
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