Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $340.96 / $340.96 / $340.96	Facility		$340.96	$340.96	$340.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.47 / $95.54 / $107.81	Professional		$85.47	$95.54	$107.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.92 / $135.35 / $195.71	Professional		$113.92	$135.35	$195.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $39.47 / $87.65 / $188.45	Facility		$39.47	$87.65	$188.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.39 / $24.25 / $144.05	Facility		$19.39	$24.25	$144.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $87.65 / $188.45	Facility		$37.15	$87.65	$188.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.57 / $97.85 / $163.51	Professional		$44.57	$97.85	$163.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $162.80 / $260.39 / $298.08	Facility		$162.80	$260.39	$298.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $116.42 / $157.49 / $203.71	Professional		$116.42	$157.49	$203.71
United Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $142.55 / $221.31	Professional		$77.95	$142.55	$221.31