Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.74 / $197.48 / $197.48	Facility		$98.74	$197.48	$197.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.98 / $81.95 / $98.74	Professional		$78.98	$81.95	$98.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.95 / $91.16 / $104.30	Professional		$82.95	$91.16	$104.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.95 / $92.32 / $176.19	Facility		$81.95	$92.32	$176.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $98.74 / $98.74	Professional		$98.74	$98.74	$98.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $98.74 / $98.74 / $79,999.20	Facility		$98.74	$98.74	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.95 / $92.32 / $182.42	Facility		$81.95	$92.32	$182.42
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 $115.40 / $173.10 / $367.93	Facility		$115.40	$173.10	$367.93
United Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $98.74 / $113.55	Professional		$98.74	$98.74	$113.55