Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $418.24 / $504.00 / $672.00	Facility		$418.24	$504.00	$672.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $842.40 / $1,260.00 / $1,861.60	Professional	AA	$842.40	$1,260.00	$1,861.60
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $130.69 / $130.69 / $130.69	Professional	QK	$130.69	$130.69	$130.69
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $84.00 / $84.00 / $1,230.23	Professional	QX	$84.00	$84.00	$1,230.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $496.00 / $582.64 / $679.28	Professional		$496.00	$582.64	$679.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $4,346.00 / $4,845.79 / $5,085.88	Facility		$4,346.00	$4,845.79	$5,085.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $340.00 / $416.00 / $552.00	Facility		$340.00	$416.00	$552.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $651.20 / $3,232.79 / $5,085.88	Facility		$651.20	$3,232.79	$5,085.88
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $325.60 / $325.60 / $325.60	Facility	QK	$325.60	$325.60	$325.60
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $325.60 / $325.60 / $325.60	Facility	QX	$325.60	$325.60	$325.60
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $325.60 / $325.60 / $325.60	Facility	QY	$325.60	$325.60	$325.60
Providence Facility/Professional Professional Modifier QK Low / Median / High Price $232.00 / $248.24 / $325.60	Professional	QK	$232.00	$248.24	$325.60
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $232.00 / $248.24 / $325.60	Professional	QX	$232.00	$248.24	$325.60
Regence BlueShield Facility/Professional Professional Modifier QK Low / Median / High Price $231.00 / $276.00 / $333.68	Professional	QK	$231.00	$276.00	$333.68
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $231.00 / $276.00 / $333.68	Professional	QX	$231.00	$276.00	$333.68