Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,951.21 / $2,951.21	Facility		$1,230.27	$2,951.21	$2,951.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,230.27 / $1,412.54	Professional		$1,174.90	$1,230.27	$1,412.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $1,778.28	Facility		$48.98	$48.98	$1,778.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $1,258.93	Professional		$41.69	$51.29	$1,258.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,819.70 / $1,905.46	Facility		$1,548.82	$1,819.70	$1,905.46
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $1,258.93 / $1,778.28	Facility		$60.26	$1,258.93	$1,778.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $1,659.59	Professional		$60.26	$79.43	$1,659.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,819.70 / $4,265.80	Facility		$1,258.93	$1,819.70	$4,265.80
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional		$1,288.25	$1,288.25	$1,288.25