Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $87.10 / $169.82	Professional		$72.44	$87.10	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $112.20	Professional		$81.28	$95.50	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $363.08	Professional		$100.00	$128.82	$363.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $107.15 / $162.18	Facility		$13.18	$107.15	$162.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $134.90 / $147.91	Professional		$123.03	$134.90	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $147.91 / $169.82	Facility		$138.04	$147.91	$169.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $147.91 / $162.18	Professional		$138.04	$147.91	$162.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $138.04 / $2,691,534.80	Facility		$72.44	$138.04	$2,691,534.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $158.49	Professional		$81.28	$81.28	$158.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $204.17 / $467.74	Facility		$144.54	$204.17	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $77.62 / $104.71	Facility		$10.47	$77.62	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $75.86 / $134.90	Professional		$70.79	$75.86	$134.90