Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $77.62	Professional		$38.02	$48.98	$77.62
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $48.98 / $104.71	Facility		$46.77	$48.98	$104.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $75.86	Professional		$38.02	$48.98	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $165.96 / $165.96	Facility		$109.65	$165.96	$165.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $48.98 / $112.20	Facility		$46.77	$48.98	$112.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $125.89 / $151.36	Facility		$95.50	$125.89	$151.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $194.98 / $263.03	Professional		$81.28	$194.98	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $141.25 / $181.97	Facility		$112.20	$141.25	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $89.13 / $213.80	Professional		$61.66	$89.13	$213.80