Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.00 / $12.00 / $12.00	Facility		$12.00	$12.00	$12.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.60 / $9.60 / $22.60	Professional		$9.60	$9.60	$22.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.53 / $195.53 / $195.53	Professional		$195.53	$195.53	$195.53
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 $9.60 / $9.60 / $20.64	Facility		$9.60	$9.60	$20.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $59.87 / $79,999.20 / $79,999.20	Facility		$59.87	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $9.60 / $9.60 / $20.64	Facility		$9.60	$9.60	$20.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $195.53 / $2,250,000.00 / $2,400,000.00	Professional		$195.53	$2,250,000.00	$2,400,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $142.16 / $235.23 / $326.66	Facility		$142.16	$235.23	$326.66
United Facility/Professional Professional Modifier Low / Median / High Price $79.29 / $79.29 / $79.29	Professional		$79.29	$79.29	$79.29