Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $1,047.13 / $1,047.13	Facility		$245.47	$1,047.13	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $407.38	Professional		$245.47	$245.47	$407.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $177.83	Professional		$169.82	$169.82	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $1,047.13	Facility		$251.19	$251.19	$1,047.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $288.40	Professional		$245.47	$245.47	$288.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $794.33 / $794.33	Facility		$309.03	$794.33	$794.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $263.03 / $1,047.13	Facility		$251.19	$263.03	$1,047.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $79.43	Professional		$70.79	$79.43	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,318.26 / $1,698.24	Facility		$912.01	$1,318.26	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,148.15 / $1,513.56	Facility		$933.25	$1,148.15	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $218.78 / $707.95	Professional		$199.53	$218.78	$707.95