Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.09 / $174.09 / $249.99	Facility		$174.09	$174.09	$249.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.10 / $174.10 / $253.70	Professional		$174.10	$174.10	$253.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.72 / $161.72 / $161.72	Professional		$161.72	$161.72	$161.72
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 $174.10 / $174.10 / $374.32	Facility		$174.10	$174.10	$374.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $241.86 / $79,999.20 / $79,999.20	Facility		$241.86	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $174.10 / $174.10 / $374.32	Facility		$174.10	$174.10	$374.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.72 / $2,250,000.00 / $2,400,000.00	Professional		$161.72	$2,250,000.00	$2,400,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $684.68 / $898.54 / $1,019.67	Facility		$684.68	$898.54	$1,019.67
United Facility/Professional Professional Modifier Low / Median / High Price $269.67 / $269.67 / $269.67	Professional		$269.67	$269.67	$269.67