Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $247.00 / $332.89 / $764.75	Facility		$247.00	$332.89	$764.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.69 / $313.70 / $638.40	Professional		$313.69	$313.70	$638.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $882.87 / $1,018.35 / $1,098.75	Professional		$882.87	$1,018.35	$1,098.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $302.36 / $415.75 / $674.46	Facility		$302.36	$415.75	$674.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $312.50 / $448.59 / $674.46	Facility		$312.50	$448.59	$674.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $312.50 / $448.81 / $688.00	Professional		$312.50	$448.81	$688.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $359.05 / $359.05 / $359.05	Professional		$359.05	$359.05	$359.05
United Facility/Professional Professional Modifier Low / Median / High Price $359.05 / $359.05 / $412.91	Professional		$359.05	$359.05	$412.91