Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,125.46 / $2,747.00 / $7,920.26	Facility		$1,125.46	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $936.94 / $1,360.00 / $1,531.22	Professional		$936.94	$1,360.00	$1,531.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $709.62 / $1,123.64 / $1,646.38	Facility		$709.62	$1,123.64	$1,646.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $765.78 / $1,094.10 / $1,208.68	Facility		$765.78	$1,094.10	$1,208.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $765.76 / $1,276.14 / $1,646.38	Facility		$765.76	$1,276.14	$1,646.38
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $191.11 / $191.11 / $191.11	Facility	AS	$191.11	$191.11	$191.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,859.35 / $10,847.34 / $13,475.61	Facility		$8,859.35	$10,847.34	$13,475.61
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $13,289.03 / $16,271.01 / $20,213.41	Facility	50	$13,289.03	$16,271.01	$20,213.41
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00