Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.61 / $218.61 / $218.61	Facility		$218.61	$218.61	$218.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $603.00	Professional		$400.00	$425.00	$603.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $263.64 / $652.41	Facility		$64.00	$263.64	$652.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $603.00 / $949.73	Facility		$425.00	$603.00	$949.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $233.47 / $593.00 / $79,999.20	Facility		$233.47	$593.00	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $603.00 / $1,296.45	Facility		$425.00	$603.00	$1,296.45
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 $637.02 / $836.00 / $970.46	Facility		$637.02	$836.00	$970.46