Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $512.86 / $512.86	Facility		$144.54	$512.86	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $239.88	Professional		$144.54	$144.54	$239.88
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 $147.91 / $147.91 / $512.86	Facility		$147.91	$147.91	$512.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $190.55	Professional		$144.54	$144.54	$190.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $234.42 / $234.42	Facility		$91.20	$234.42	$234.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $154.88 / $512.86	Facility		$147.91	$154.88	$512.86
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 $295.12 / $426.58 / $794.33	Facility		$295.12	$426.58	$794.33
United Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $309.03 / $407.38	Facility		$251.19	$309.03	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19