Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,611.19 / $13,570.00 / $35,128.85	Facility		$2,611.19	$13,570.00	$35,128.85
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,307.49 / $1,307.49 / $1,460.30	Facility	52	$1,307.49	$1,307.49	$1,460.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,904.87 / $2,706.46 / $3,047.21	Professional		$1,904.87	$2,706.46	$3,047.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,030.14 / $3,329.25 / $4,364.80	Facility		$2,030.14	$3,329.25	$4,364.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,954.15 / $2,380.51 / $3,301.76	Facility		$1,954.15	$2,380.51	$3,301.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,030.14 / $3,166.00 / $4,364.80	Facility		$2,030.14	$3,166.00	$4,364.80
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,109.88 / $2,109.88 / $2,109.88	Facility	62	$2,109.88	$2,109.88	$2,109.88
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $540.13 / $540.13 / $540.13	Facility	80	$540.13	$540.13	$540.13
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $459.11 / $459.11 / $459.11	Facility	AS	$459.11	$459.11	$459.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23,621.76 / $29,424.68 / $38,534.69	Facility		$23,621.76	$29,424.68	$38,534.69
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $26,100.00 / $51,981.00	Facility		$3,340.00	$26,100.00	$51,981.00