Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,436.86 / $11,050.00 / $20,364.04	Facility		$1,436.86	$11,050.00	$20,364.04
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $7,120.14 / $17,470.77 / $25,423.82	Facility	50	$7,120.14	$17,470.77	$25,423.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,038.33 / $1,481.34 / $1,667.84	Professional		$1,038.33	$1,481.34	$1,667.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $755.54 / $1,259.10 / $1,790.11	Facility		$755.54	$1,259.10	$1,790.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $897.29 / $1,216.15 / $1,316.55	Facility		$897.29	$1,216.15	$1,316.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $755.54 / $1,555.20 / $7,952.00	Facility		$755.54	$1,555.20	$7,952.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $248.99 / $248.99 / $248.99	Facility	80	$248.99	$248.99	$248.99
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $211.64 / $211.64 / $211.64	Facility	AS	$211.64	$211.64	$211.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,624.30 / $17,810.43 / $21,600.03	Facility		$13,624.30	$17,810.43	$21,600.03
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $20,436.45 / $26,715.66 / $32,400.05	Facility	50	$20,436.45	$26,715.66	$32,400.05
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