Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.99 / $103.84 / $162.09	Professional		$44.99	$103.84	$162.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.30 / $135.26 / $156.94	Professional		$118.30	$135.26	$156.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $52.96 / $162.09 / $348.49	Facility		$52.96	$162.09	$348.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $105.52 / $125.80 / $166.16	Facility		$105.52	$125.80	$166.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $162.09 / $348.49	Facility		$64.00	$162.09	$348.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $131.71 / $151.30 / $346.77	Professional		$131.71	$151.30	$346.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $463.08 / $882.62 / $1,182.96	Facility		$463.08	$882.62	$1,182.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.84 / $149.91 / $249.19	Professional		$127.84	$149.91	$249.19
United Facility/Professional Professional Modifier Low / Median / High Price $71.76 / $292.33 / $511.57	Professional		$71.76	$292.33	$511.57