Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $53.70	Professional		$52.48	$52.48	$53.70
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $0.36 / $0.38 / $53.70	Facility		$0.36	$0.38	$53.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $104.71 / $138.04	Facility		$53.70	$104.71	$138.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $0.36 / $0.38 / $53.70	Facility		$0.36	$0.38	$53.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $79.43	Professional		$60.26	$79.43	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $147.91 / $213.80	Facility		$91.20	$147.91	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $331.13 / $426.58	Facility		$263.03	$331.13	$426.58