Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.60 / $108.60 / $108.60	Facility		$108.60	$108.60	$108.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $148.96	Professional		$137.93	$137.93	$148.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.12 / $256.16 / $329.31	Facility		$130.12	$256.16	$329.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $162.65	Professional		$137.93	$137.93	$162.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $189.07 / $265.02 / $666.02	Professional		$189.07	$265.02	$666.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.60 / $137.93 / $295.17	Facility		$108.60	$137.93	$295.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $146.19 / $179.31	Professional		$137.93	$146.19	$179.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.23 / $137.93 / $286.26	Facility		$44.23	$137.93	$286.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $172.41 / $296.55	Facility		$137.93	$172.41	$296.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $193.23 / $2,250,000.00	Professional		$137.93	$193.23	$2,250,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.03 / $137.93 / $137.93	Professional		$131.03	$137.93	$137.93
United Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $158.62	Professional		$137.93	$137.93	$158.62