Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $523.71 / $523.71 / $523.71	Facility		$523.71	$523.71	$523.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.41 / $134.63 / $337.57	Professional		$103.41	$134.63	$337.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.11 / $213.57 / $304.42	Professional		$103.11	$213.57	$304.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.35 / $125.10 / $289.45	Facility		$112.35	$125.10	$289.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $126.23 / $201.14 / $210.38	Facility		$126.23	$201.14	$210.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.35 / $134.63 / $162.83	Facility		$112.35	$134.63	$162.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $152.66 / $152.66 / $155.02	Professional		$152.66	$152.66	$155.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $170.03 / $208.00 / $334.66	Professional		$170.03	$208.00	$334.66
United Facility/Professional Professional Modifier Low / Median / High Price $121.62 / $121.62 / $227.32	Professional		$121.62	$121.62	$227.32