Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $52.00 / $52.00	Professional		$52.00	$52.00	$52.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $21.25 / $21.25	Professional		$21.25	$21.25	$21.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $116.01 / $142.78 / $167.67	Professional		$116.01	$142.78	$167.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $61.00 / $111.80	Facility		$52.00	$61.00	$111.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.95 / $59.22 / $64.05	Professional		$57.95	$59.22	$64.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $45.20 / $59.22 / $70.15	Facility		$45.20	$59.22	$70.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $45.20 / $61.00 / $67.09	Professional		$45.20	$61.00	$67.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $61.00 / $111.80	Facility		$52.00	$61.00	$111.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $59.22 / $2,250,000.00	Professional		$21.25	$59.22	$2,250,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $59.22 / $62.77 / $246.16	Facility		$59.22	$62.77	$246.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $67.09 / $67.09	Professional		$63.75	$67.09	$67.09
United Facility/Professional Professional Modifier Low / Median / High Price $35.53 / $35.53 / $59.22	Professional		$35.53	$35.53	$59.22