Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.88 / $7,187.00 / $26,469.87	Facility		$1,949.88	$7,187.00	$26,469.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,549.54 / $2,210.41 / $2,488.69	Professional		$1,549.54	$2,210.41	$2,488.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,130.74 / $1,884.38 / $2,687.94	Facility		$1,130.74	$1,884.38	$2,687.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,338.67 / $1,851.21 / $1,965.88	Facility		$1,338.67	$1,851.21	$1,965.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,130.74 / $2,145.08 / $2,497.92	Facility		$1,130.74	$2,145.08	$2,497.92
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $371.56 / $371.56 / $371.56	Facility	80	$371.56	$371.56	$371.56
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $315.83 / $315.83 / $315.83	Facility	AS	$315.83	$315.83	$315.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23,713.19 / $31,052.21 / $38,534.69	Facility		$23,713.19	$31,052.21	$38,534.69
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00