Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $15.14 / $616.60	Facility		$15.14	$15.14	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $616.60 / $812.83	Professional		$331.13	$616.60	$812.83
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 $616.60 / $616.60 / $1,071.52	Facility		$616.60	$616.60	$1,071.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $812.83	Professional		$616.60	$616.60	$812.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,819.70 / $1,819.70	Facility		$724.44	$1,819.70	$1,819.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $616.60 / $1,071.52	Facility		$489.78	$616.60	$1,071.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $4.47 / $4.47 / $79.43	Professional		$4.47	$4.47	$79.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,818.38 / $3,548.13	Facility		$2,238.72	$2,818.38	$3,548.13
United Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,570.40 / $3,388.44	Facility		$2,089.30	$2,570.40	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional		$1,071.52	$1,071.52	$1,071.52