Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.81 / $49.01 / $49.01	Professional		$40.81	$49.01	$49.01
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $49.01 / $49.01 / $105.37	Facility		$49.01	$49.01	$105.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.70 / $136.40 / $166.16	Facility		$99.70	$136.40	$166.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $49.01 / $49.01 / $105.37	Facility		$49.01	$49.01	$105.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.72 / $55.72 / $55.72	Professional		$55.72	$55.72	$55.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.48 / $125.30 / $153.24	Facility		$95.48	$125.30	$153.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.25 / $203.48 / $260.14	Professional		$127.25	$203.48	$260.14
United Facility/Professional Professional Modifier Low / Median / High Price $65.19 / $100.37 / $250.00	Professional		$65.19	$100.37	$250.00