Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $289.19 / $289.19 / $3,861.00	Facility		$289.19	$289.19	$3,861.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $171.15 / $392.08	Professional		$171.15	$171.15	$392.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $171.15 / $171.15 / $367.97	Facility		$171.15	$171.15	$367.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $397.12 / $79,999.20 / $79,999.20	Facility		$397.12	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $171.15 / $171.15 / $367.97	Facility		$171.15	$171.15	$367.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,250,000.00 / $2,250,000.00 / $2,400,000.00	Professional		$2,250,000.00	$2,250,000.00	$2,400,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,070.31 / $1,416.89 / $1,568.82	Facility		$1,070.31	$1,416.89	$1,568.82
United Facility/Professional Professional Modifier Low / Median / High Price $699.93 / $699.93 / $699.93	Professional		$699.93	$699.93	$699.93