Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $2,884.03 / $7,943.28	Facility		$549.54	$2,884.03	$7,943.28
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility	50	$3,890.45	$3,890.45	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $1,071.52 / $2,691.53	Professional		$407.38	$1,071.52	$2,691.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $1,380.38 / $5,495.41	Facility		$302.00	$1,380.38	$5,495.41
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility	50	$3,890.45	$3,890.45	$3,890.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $2,137.96 / $2,238.72	Facility		$1,445.44	$2,137.96	$2,238.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $1,122.02 / $2,570.40	Facility		$281.84	$1,122.02	$2,570.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $10,964.78 / $13,182.57	Facility		$6,918.31	$10,964.78	$13,182.57
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,471.29 / $16,595.87 / $19,952.62	Facility	50	$10,471.29	$16,595.87	$19,952.62
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $10,232.93 / $15,135.61	Facility		$1,995.26	$10,232.93	$15,135.61