Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,761.43 / $1,937.39 / $2,159.01	Facility		$1,761.43	$1,937.39	$2,159.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,398.41 / $1,983.30 / $2,232.98	Professional		$1,398.41	$1,983.30	$2,232.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $941.92 / $1,697.14 / $2,581.50	Facility		$941.92	$1,697.14	$2,581.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,255.91 / $1,703.52 / $1,824.41	Facility		$1,255.91	$1,703.52	$1,824.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $941.92 / $1,927.96 / $2,328.03	Facility		$941.92	$1,927.96	$2,328.03
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $344.71 / $344.71 / $344.71	Facility	80	$344.71	$344.71	$344.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,709.63 / $4,709.63 / $4,709.63	Facility		$4,709.63	$4,709.63	$4,709.63
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