Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,970.00 / $2,970.00 / $2,970.00	Facility		$2,970.00	$2,970.00	$2,970.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,232.55 / $1,232.55 / $1,262.25	Professional		$1,232.55	$1,232.55	$1,262.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.92 / $1,311.75 / $1,762.55	Facility		$60.92	$1,311.75	$1,762.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.90 / $49.54 / $1,218.07	Professional		$41.90	$49.54	$1,218.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,566.49 / $79,999.20 / $79,999.20	Facility		$1,566.49	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.48 / $1,311.75 / $2,475.00	Facility		$64.48	$1,311.75	$2,475.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,232.55 / $1,546.88 / $1,546.88	Professional		$1,232.55	$1,546.88	$1,546.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,250.92 / $1,905.29 / $4,247.45	Facility		$1,250.92	$1,905.29	$4,247.45