Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $218.78 / $245.47	Professional		$131.83	$218.78	$245.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $144.54 / $288.40	Facility		$131.83	$144.54	$288.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $245.47	Professional		$131.83	$131.83	$245.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $239.88 / $239.88	Facility		$51.29	$239.88	$239.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $1,659,586.91	Facility		$131.83	$131.83	$1,659,586.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $79.43	Professional		$70.79	$79.43	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $169.82 / $213.80	Facility		$138.04	$169.82	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $194.98 / $257.04	Facility		$158.49	$194.98	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95