Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $275.42	Professional		$112.20	$141.25	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $154.88	Professional		$107.15	$125.89	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $467.74	Professional		$125.89	$162.18	$467.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $134.90 / $363.08	Facility		$29.51	$134.90	$363.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $302.00	Professional		$169.82	$213.80	$302.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $181.97 / $371.54	Facility		$173.78	$181.97	$371.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $288.40	Professional		$173.78	$181.97	$288.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $309.03 / $2,691,534.80	Facility		$117.49	$309.03	$2,691,534.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $245.47	Professional		$87.10	$107.15	$245.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $316.23 / $724.44	Facility		$177.83	$316.23	$724.44
United Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $100.00 / $134.90	Facility		$13.49	$100.00	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $223.87	Professional		$112.20	$154.88	$223.87