Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $208.93 / $7,943.28	Facility		$109.65	$208.93	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $158.49 / $208.93	Professional		$123.03	$158.49	$208.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $128.82 / $239.88	Facility		$83.18	$128.82	$239.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $162.18 / $173.78	Facility		$144.54	$162.18	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $120.23 / $204.17	Facility		$83.18	$120.23	$204.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $10,232.93 / $37,153.52	Facility		$2,454.71	$10,232.93	$37,153.52