Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $5,116.62 / $7,920.26	Facility		$2,747.00	$5,116.62	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,547.45 / $5,089.80 / $5,730.60	Professional		$3,547.45	$5,089.80	$5,730.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,929.87 / $4,551.56 / $6,300.56	Facility		$2,929.87	$4,551.56	$6,300.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,246.15 / $4,321.43 / $4,649.13	Facility		$3,246.15	$4,321.43	$4,649.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,929.87 / $4,882.63 / $6,299.22	Facility		$2,929.87	$4,882.63	$6,299.22
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $869.55 / $869.55 / $869.55	Facility	80	$869.55	$869.55	$869.55
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $739.12 / $739.12 / $739.12	Facility	AS	$739.12	$739.12	$739.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,901.77 / $11,901.77 / $11,901.77	Facility		$11,901.77	$11,901.77	$11,901.77
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $17,852.66 / $17,852.66 / $17,852.66	Facility	50	$17,852.66	$17,852.66	$17,852.66
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