Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.83 / $268.83 / $399.00	Facility		$91.83	$268.83	$399.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.63 / $114.73 / $114.73	Professional		$51.63	$114.73	$114.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.62 / $1.62 / $1.62	Professional		$1.62	$1.62	$1.62
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 $114.73 / $114.73 / $246.67	Facility		$114.73	$114.73	$246.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.56 / $79,999.20 / $79,999.20	Facility		$72.56	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.73 / $114.73 / $246.67	Facility		$114.73	$114.73	$246.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $1.62 / $2,250,000.00 / $2,400,000.00	Professional		$1.62	$2,250,000.00	$2,400,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $207.87 / $272.80 / $313.61	Facility		$207.87	$272.80	$313.61
United Facility/Professional Professional Modifier Low / Median / High Price $79.29 / $79.29 / $79.29	Professional		$79.29	$79.29	$79.29