Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $5,116.62 / $8,728.00	Facility		$988.00	$5,116.62	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $74.87 / $87.28	Professional		$69.48	$74.87	$87.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.13 / $162.02 / $194.38	Professional		$139.13	$162.02	$194.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $91.64 / $187.65	Facility		$87.28	$91.64	$187.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.25 / $137.62 / $152.09	Facility		$91.25	$137.62	$152.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $89.90 / $187.65	Facility		$87.28	$89.90	$187.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.83 / $102.83 / $155.72	Professional		$102.83	$102.83	$155.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $122.38 / $177.17 / $238.12	Professional		$122.38	$177.17	$238.12
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 $111.23 / $154.35 / $234.62	Professional		$111.23	$154.35	$234.62