Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.36 / $45.36 / $220.85	Facility		$45.36	$45.36	$220.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.57 / $42.57 / $205.49	Facility	26	$42.57	$42.57	$205.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.28 / $39.45 / $77.23	Professional		$12.28	$39.45	$77.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $42.57 / $90.87	Professional	26	$12.28	$42.57	$90.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5.25 / $5.25 / $9.39	Facility		$5.25	$5.25	$9.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $43.45 / $43.45	Professional		$43.45	$43.45	$43.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $40.47 / $40.47	Professional	26	$40.47	$40.47	$40.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $106.28 / $117.15	Professional		$46.76	$106.28	$117.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.69 / $98.85 / $108.97	Professional	26	$43.69	$98.85	$108.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $39.45 / $64.03 / $137.66	Facility		$39.45	$64.03	$137.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $76.98 / $82.65 / $154.91	Professional		$76.98	$82.65	$154.91
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.58 / $79.62 / $144.29	Professional	26	$72.58	$79.62	$144.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $59.09 / $93.95 / $98.49	Facility		$59.09	$93.95	$98.49
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $27.56 / $74.79 / $91.79	Facility	26	$27.56	$74.79	$91.79
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $38.22 / $91.79	Professional	26	$21.84	$38.22	$91.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $8.09 / $67.52 / $126.16	Facility		$8.09	$67.52	$126.16
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $106.80 / $118.42 / $118.42	Facility	26	$106.80	$118.42	$118.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $96.99 / $2,400,000.00	Professional		$43.45	$96.99	$2,400,000.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $86.94 / $118.42	Professional	26	$36.71	$86.94	$118.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.83 / $93.31 / $154.19	Professional		$50.83	$93.31	$154.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $50.83 / $87.39 / $143.71	Professional	26	$50.83	$87.39	$143.71
United Facility/Professional Professional Modifier Low / Median / High Price $22.89 / $36.06 / $154.93	Professional		$22.89	$36.06	$154.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.88 / $36.04 / $145.44	Professional	26	$22.88	$36.04	$145.44