Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,394.59 / $20,400.00 / $43,780.33	Facility		$1,394.59	$20,400.00	$43,780.33
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $278.92 / $278.92 / $309.80	Facility	53	$278.92	$278.92	$309.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,006.23 / $1,423.07 / $1,619.97	Professional		$1,006.23	$1,423.07	$1,619.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $617.13 / $1,140.67 / $1,714.99	Facility		$617.13	$1,140.67	$1,714.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $938.96 / $1,225.76 / $1,307.17	Facility		$938.96	$1,225.76	$1,307.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $617.13 / $1,243.97 / $1,714.99	Facility		$617.13	$1,243.97	$1,714.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47,293.80 / $47,293.80 / $47,293.80	Facility		$47,293.80	$47,293.80	$47,293.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $22,177.00 / $68,672.00	Facility		$3,028.00	$22,177.00	$68,672.00