Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.11 / $93.11 / $93.11	Facility		$93.11	$93.11	$93.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $103.71	Professional		$89.41	$89.41	$103.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.35 / $123.36 / $184.06	Facility		$84.35	$123.36	$184.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $105.43	Professional		$89.41	$89.41	$105.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $176.05 / $216.00 / $250.10	Professional		$176.05	$216.00	$250.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $93.11 / $247.50	Facility		$89.41	$93.11	$247.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $94.77 / $116.23	Professional		$89.41	$94.77	$116.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $83.49 / $93.11 / $185.97	Facility		$83.49	$93.11	$185.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $107.29 / $247.50	Facility		$89.41	$107.29	$247.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $117.69 / $2,250,000.00	Professional		$89.41	$117.69	$2,250,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $84.94 / $89.41 / $89.41	Professional		$84.94	$89.41	$89.41
United Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $102.82	Professional		$89.41	$89.41	$102.82