Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $6,629.40 / $8,728.00	Facility		$2,747.00	$6,629.40	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,045.66 / $3,045.66 / $4,704.00	Professional		$3,045.66	$3,045.66	$4,704.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,315.62 / $8,714.00 / $13,964.00	Facility		$5,315.62	$8,714.00	$13,964.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,647,300.28 / $1,647,300.28 / $1,647,300.28	Facility		$1,647,300.28	$1,647,300.28	$1,647,300.28
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
United Facility/Professional Facility Modifier Low / Median / High Price $7,612.00 / $20,708.00 / $24,872.00	Facility		$7,612.00	$20,708.00	$24,872.00