Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.50 / $4,354.50 / $8,728.00	Facility		$122.50	$4,354.50	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.87 / $85.70 / $99.60	Professional		$63.87	$85.70	$99.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.74 / $175.24 / $227.50	Professional		$141.74	$175.24	$227.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $65.18 / $99.60 / $180.94	Facility		$65.18	$99.60	$180.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43.37 / $72.29 / $78.70	Facility		$43.37	$72.29	$78.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.84 / $99.60 / $180.94	Facility		$58.84	$99.60	$180.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.84 / $96.17 / $161.31	Professional		$58.84	$96.17	$161.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $156.49 / $195.23 / $308.02	Professional		$156.49	$195.23	$308.02
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $95.48 / $137.15 / $218.09	Professional		$95.48	$137.15	$218.09