Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,380.38 / $1,995.26	Facility		$741.31	$1,380.38	$1,995.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $912.01	Professional		$537.03	$537.03	$912.01
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $741.31 / $1,288.25	Facility		$537.03	$741.31	$1,288.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $1,819.70	Professional		$537.03	$537.03	$1,819.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $309.03 / $331.13	Facility		$218.78	$309.03	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $645.65 / $1,047.13	Facility		$537.03	$645.65	$1,047.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $3,311.31 / $3,311.31	Professional		$79.43	$3,311.31	$3,311.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,511.89 / $3,162.28	Facility		$1,905.46	$2,511.89	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,951.21 / $3,890.45	Facility		$2,398.83	$2,951.21	$3,890.45