Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $306.27 / $569.40 / $1,221.11	Facility		$306.27	$569.40	$1,221.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.74 / $317.60 / $317.60	Professional		$207.74	$317.60	$317.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.76 / $116.76 / $116.76	Professional		$116.76	$116.76	$116.76
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 $317.60 / $317.60 / $682.84	Facility		$317.60	$317.60	$682.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $180.82 / $79,999.20 / $79,999.20	Facility		$180.82	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $317.60 / $317.60 / $682.84	Facility		$317.60	$317.60	$682.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.76 / $2,250,000.00 / $2,400,000.00	Professional		$116.76	$2,250,000.00	$2,400,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $516.15 / $677.37 / $778.15	Facility		$516.15	$677.37	$778.15
United Facility/Professional Professional Modifier Low / Median / High Price $194.93 / $194.93 / $194.93	Professional		$194.93	$194.93	$194.93