Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $151.36 / $177.83	Facility		$89.13	$151.36	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $123.03	Professional		$89.13	$93.33	$123.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $93.33 / $147.91	Facility		$91.20	$93.33	$147.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $107.15	Professional		$89.13	$89.13	$107.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $72.44 / $72.44	Facility		$28.18	$72.44	$72.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $97.72 / $162.18	Facility		$91.20	$97.72	$162.18
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 $58.88 / $91.20 / $112.20	Facility		$58.88	$91.20	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $107.15 / $141.25	Facility		$87.10	$107.15	$141.25