Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.86 / $84.86 / $84.86	Facility		$84.86	$84.86	$84.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.17 / $78.17 / $90.68	Professional		$78.17	$78.17	$90.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.73 / $122.69 / $165.52	Facility		$73.73	$122.69	$165.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.17 / $78.17 / $92.18	Professional		$78.17	$78.17	$92.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $166.17 / $196.52 / $248.25	Professional		$166.17	$196.52	$248.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $78.17 / $84.86 / $167.28	Facility		$78.17	$84.86	$167.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.17 / $82.86 / $97.71	Professional		$78.17	$82.86	$97.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $78.17 / $84.81 / $162.59	Facility		$78.17	$84.81	$162.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $78.17 / $86.70 / $168.07	Facility		$78.17	$86.70	$168.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $78.17 / $107.33 / $2,250,000.00	Professional		$78.17	$107.33	$2,250,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.26 / $78.17 / $78.17	Professional		$74.26	$78.17	$78.17
United Facility/Professional Professional Modifier Low / Median / High Price $78.17 / $78.17 / $89.90	Professional		$78.17	$78.17	$89.90