Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,178.67 / $9,972.00 / $20,400.00	Facility		$2,178.67	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,586.42 / $2,265.59 / $2,550.83	Professional		$1,586.42	$2,265.59	$2,550.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,280.17 / $1,996.62 / $2,752.37	Facility		$1,280.17	$1,996.62	$2,752.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,380.83 / $1,856.27 / $2,024.74	Facility		$1,380.83	$1,856.27	$2,024.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,280.17 / $2,133.40 / $2,647.22	Facility		$1,280.17	$2,133.40	$2,647.22
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $382.87 / $382.87 / $382.87	Facility	80	$382.87	$382.87	$382.87
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $325.44 / $325.44 / $325.44	Facility	AS	$325.44	$325.44	$325.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,039.66 / $5,039.66 / $5,039.66	Facility		$5,039.66	$5,039.66	$5,039.66
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