Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,144.52 / $5,649.00 / $15,341.00	Facility		$1,144.52	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $844.44 / $1,227.86 / $1,382.46	Professional		$844.44	$1,227.86	$1,382.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $694.93 / $1,083.74 / $1,494.10	Facility		$694.93	$1,083.74	$1,494.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $726.27 / $1,000.31 / $1,085.40	Facility		$726.27	$1,000.31	$1,085.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $694.93 / $1,254.59 / $3,274.00	Facility		$694.93	$1,254.59	$3,274.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $171.24 / $171.24 / $171.24	Facility	AS	$171.24	$171.24	$171.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $54,340.97 / $73,520.14 / $86,036.51	Facility		$54,340.97	$73,520.14	$86,036.51
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $81,511.46 / $110,280.21 / $129,054.77	Facility	50	$81,511.46	$110,280.21	$129,054.77
United Facility/Professional Facility Modifier Low / Median / High Price $4,252.00 / $37,152.00 / $65,339.00	Facility		$4,252.00	$37,152.00	$65,339.00