Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,769.52 / $4,704.00 / $8,728.00	Facility		$1,769.52	$4,704.00	$8,728.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $808.01 / $884.76 / $990.98	Facility	52	$808.01	$884.76	$990.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,292.55 / $1,844.34 / $2,076.54	Professional		$1,292.55	$1,844.34	$2,076.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,052.78 / $1,641.81 / $2,263.48	Facility		$1,052.78	$1,641.81	$2,263.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,130.82 / $1,527.46 / $1,613.36	Facility		$1,130.82	$1,527.46	$1,613.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,052.78 / $1,943.19 / $2,774.42	Facility		$1,052.78	$1,943.19	$2,774.42
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $303.33 / $303.33 / $303.33	Facility	80	$303.33	$303.33	$303.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $49,533.96 / $65,887.53 / $75,513.42	Facility		$49,533.96	$65,887.53	$75,513.42
United Facility/Professional Facility Modifier Low / Median / High Price $3,960.00 / $30,636.00 / $55,640.00	Facility		$3,960.00	$30,636.00	$55,640.00