Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $857.92 / $5,649.00 / $15,341.00	Facility		$857.92	$5,649.00	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $627.51 / $905.98 / $1,020.05	Professional		$627.51	$905.98	$1,020.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $519.69 / $789.77 / $1,117.33	Facility		$519.69	$789.77	$1,117.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $556.71 / $749.06 / $815.39	Facility		$556.71	$749.06	$815.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $519.69 / $940.39 / $2,724.00	Facility		$519.69	$940.39	$2,724.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $18,832.95 / $35,824.41 / $50,994.29	Facility		$18,832.95	$35,824.41	$50,994.29
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