Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.83 / $212.83 / $212.83	Facility		$212.83	$212.83	$212.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.22 / $104.22 / $304.11	Professional		$104.22	$104.22	$304.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.22 / $109.43 / $224.07	Facility		$104.22	$109.43	$224.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $105.88 / $105.88 / $105.88	Professional		$105.88	$105.88	$105.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $150.81 / $383.00 / $79,999.20	Facility		$150.81	$383.00	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.22 / $126.05 / $224.07	Facility		$104.22	$126.05	$224.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,800,000.00 / $2,250,000.00 / $2,400,000.00	Professional		$1,800,000.00	$2,250,000.00	$2,400,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $396.54 / $592.05 / $669.14	Facility		$396.54	$592.05	$669.14