Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $15.00 / $15.00	Facility		$15.00	$15.00	$15.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $617.41 / $617.41 / $817.27	Professional		$617.41	$617.41	$817.27
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 $617.41 / $617.41 / $1,327.45	Facility		$617.41	$617.41	$1,327.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $720.67 / $79,999.20 / $79,999.20	Facility		$720.67	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $617.41 / $617.41 / $1,327.45	Facility		$617.41	$617.41	$1,327.45
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 $2,260.23 / $2,831.27 / $3,494.02	Facility		$2,260.23	$2,831.27	$3,494.02
United Facility/Professional Professional Modifier Low / Median / High Price $1,080.70 / $1,080.70 / $1,080.70	Professional		$1,080.70	$1,080.70	$1,080.70