Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.65 / $140.96 / $523.16	Facility		$63.65	$140.96	$523.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.01 / $87.35 / $107.44	Professional		$74.01	$87.35	$107.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.12 / $87.12 / $87.12	Professional		$87.12	$87.12	$87.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $170.00 / $178.00	Professional		$150.00	$170.00	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.35 / $87.35 / $160.72	Facility		$87.35	$87.35	$160.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $79,999.20 / $79,999.20	Facility		$200.00	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.35 / $87.35 / $187.80	Facility		$87.35	$87.35	$187.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.12 / $2,250,000.00 / $2,400,000.00	Professional		$87.12	$2,250,000.00	$2,400,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $98.30 / $98.30 / $98.30	Professional		$98.30	$98.30	$98.30