Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.90 / $68.63 / $109.47	Professional		$63.90	$68.63	$109.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.17 / $82.60 / $104.63	Professional		$71.17	$82.60	$104.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.93 / $42.95 / $84.66	Facility		$28.93	$42.95	$84.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.05 / $73.41 / $74.37	Facility		$61.05	$73.41	$74.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.17 / $49.70 / $101.76	Facility		$24.17	$49.70	$101.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.92 / $48.92 / $48.92	Professional		$48.92	$48.92	$48.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $69.65 / $100.26	Professional		$42.50	$69.65	$100.26
United Facility/Professional Professional Modifier Low / Median / High Price $40.17 / $57.81 / $101.34	Professional		$40.17	$57.81	$101.34