Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $316.23 / $478.63	Facility		$257.04	$316.23	$478.63
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $524.81 / $524.81 / $524.81	Professional	AA	$524.81	$524.81	$524.81
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $524.81 / $524.81 / $912.01	Professional	QX	$524.81	$524.81	$912.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $346.74 / $416.87	Professional		$309.03	$346.74	$416.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $4,073.80	Facility		$229.09	$229.09	$4,073.80
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $524.81 / $524.81 / $524.81	Professional	AA	$524.81	$524.81	$524.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $257.04 / $346.74	Facility		$218.78	$257.04	$346.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $4,466.84 / $6,309.57	Facility		$67.61	$4,466.84	$6,309.57
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	QX	$151.36	$151.36	$151.36
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	QY	$151.36	$151.36	$151.36
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $144.54 / $162.18 / $208.93	Professional	QX	$144.54	$162.18	$208.93
Regence BlueShield Facility/Professional Professional Modifier QY Low / Median / High Price $144.54 / $162.18 / $208.93	Professional	QY	$144.54	$162.18	$208.93