Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.29 / $4,704.00 / $8,728.00	Facility		$181.29	$4,704.00	$8,728.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,944.70 / $6,944.70 / $6,944.70	Facility	50	$6,944.70	$6,944.70	$6,944.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $153.97 / $500.80 / $1,321.67	Professional		$153.97	$500.80	$1,321.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $107.68 / $554.05 / $1,391.58	Facility		$107.68	$554.05	$1,391.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $172.20 / $989.52 / $1,159.09	Facility		$172.20	$989.52	$1,159.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.68 / $814.61 / $1,444.18	Facility		$107.68	$814.61	$1,444.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,993.29 / $6,006.10 / $7,624.85	Facility		$4,993.29	$6,006.10	$7,624.85
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $7,489.94 / $9,009.15 / $11,437.28	Facility	50	$7,489.94	$9,009.15	$11,437.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,517.00 / $7,693.76	Facility		$1,689.00	$5,517.00	$7,693.76